title: A case of dilated cardiomyopathy and severe mitral regurgitation treated using a combined percutaneous approach of MitraClip followed by CARILLON® mitral contour system.
abstract: Functional mitral regurgitation (FMR) is common in severe heart failure. Medical therapy is the standard of care since the role of surgery is less established. Various trans-catheter percutaneous techniques may avoid the risks of surgery; such as edge-to-edge repair using MitraClip system (Abbott Vascular, Illinois, USA) and CARILLON® Mitral Contour System® (Model XE2; Cardiac Dimensions., Kirkland, WA, USA). We present the case of a 41-year-old man with severe dilated cardiomyopathy, NYHA IIIb, and grade 3 MR. Due to high surgical risk (logistic EuroScore 35.1) he initially underwent single MitraClip insertion with significant echocardiographic and clinical improvement (MR reduced from 3+ to 1+, NYHA classes III to II). Fifteen months later, he developed heart failure symptoms due to recurrence of severe MR and was retreated with percutaneous CARILLON® Mitral Contour System® with resolution of MR and doing well at nine-month follow-up. A combined approach of MitraClip followed by percutaneous mitral annuloplasty demonstrated clinically meaningful reduction of MR and resulted in significant symptomatic improvement for up to 6months. Follow-up for longer period is warranted to ensure sustained favorable outcome.
authors.affiliation: Cardiology Department, Al Qassimi Hospital, Sharjah, UAE.
authors.forename: Nagwa
authors.initials: N
authors.lastname: Abdelrahman
authors.affiliation: Cardiovascular Medicine, University of Toledo Medical Center, OH, USA.
authors.forename: Mohammed Andaleeb
authors.initials: MA
authors.lastname: Chowdhury
authors.affiliation: Cardiology Department, Al Qassimi Hospital, Sharjah, UAE.
authors.forename: Arif
authors.initials: A
authors.lastname: Al Nooryani
authors.affiliation: Cardiology Department, Al Qassimi Hospital, Sharjah, UAE. Electronic address: welabbassi@yahoo.com.
authors.forename: Wael
authors.initials: W
authors.lastname: Elabbassi
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000175:diagnosis; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D058386:Mitral Valve Annuloplasty / Q000295:instrumentation*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012008:Recurrence; D019233:Retreatment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carillon; MitraClip; Mitral regurgitation; Percutaneous mitral valve repair