title: Catheter-based intervention for symptomatic patient with severe mitral regurgitation and very poor left ventricular systolic function - Safe but no room for complacency.
abstract: Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip(®) can be used safely to reduce the severity of MR even in patients with advanced heart failure and is associated with improved symptoms, quality of life and exercise tolerance. However, a few patients with very poor left ventricular systolic function may experience significant haemodynamic disturbance in the peri-procedural period. We present three such patients, highlighting some of the potential problems encountered and discuss their possible pathophysiological mechanisms and safety measures.
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Poay Huan
authors.initials: PH
authors.lastname: Loh
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Christos V
authors.initials: CV
authors.lastname: Bourantas
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Pak Hei
authors.initials: PH
authors.lastname: Chan
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Nikolaj
authors.initials: N
authors.lastname: Ihlemann
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Fin
authors.initials: F
authors.lastname: Gustafsson
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Clark
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Susanna
authors.initials: S
authors.lastname: Price
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Carlo Di
authors.initials: CD
authors.lastname: Mario
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Neil
authors.initials: N
authors.lastname: Moat
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Farqad
authors.initials: F
authors.lastname: Alamgir
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Estevez-Loureiro
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Lars
authors.initials: L
authors.lastname: Søndergaard
authors.affiliation: Poay Huan Loh, National University Heart Center Singapore, Singapore 169856, Singapore.
authors.forename: Olaf
authors.initials: O
authors.lastname: Franzen
keywords: Chronic heart failure; Left ventricular systolic dysfunction; MitraClip; Mitral regurgitation; Mitral valve; Percutaneous