Unsuccessful Redo MitraClip Procedure Leads to Acute Right Ventricular Failure in a Patient With Homozygous Familial Hypercholesterolemia and a Preexisting Atrial Septal Defect.
The MitraClip procedure is an emerging endovascular technique for treating mitral regurgitation and an attractive alternative for patients who are at high risk for open heart mitral valve repair or replacement. We present the case of a failed redo MitraClip procedure that led to acute right ventricular failure in a patient with homozygous familial hypercholesterolemia and a preexisting secundum atrial septal defect. We highlight the sequelae of the failed redo MitraClip procedure and the anesthetic challenges associated with the emergent redo sternotomy and cardiopulmonary bypass procedure required to replace the mitral valve and repair the tricuspid valve and atrial septal defect.
From the *University of Texas Health Science Center, Houston, Texas; †Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas; and ‡University of Kentucky College of Medicine, Lexington, Kentucky.
Poovendran
P
Saththasivam
Elizabeth
E
Herrera
Gerald
G
Lawrie
Odeaa Al
OA
Jabbari
Collin M
CM
Barker
Roy
R
Sheinbaum
D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology*; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000235:genetics / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006720:Homozygote; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000150:complications / Q000235:genetics / Q000601:surgery*; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology*