title: Cardiac resynchronization therapy before and after MitraClip implantation: An advantageous upgrading to reduce mitral regurgitation.
abstract: MitraClip therapy has been proposed as therapeutic option in selected patients with degenerative or functional mitral regurgitation (FMR), leading to clinical and prognostic benefits. Previous studies demonstrated the safety and the efficacy of MitraClip therapy on symptoms and left ventricular remodeling in cardiac resynchronization therapy (CRT) non-responder patients. We report a case of a CRT non-responder patient treated with MitraClip implantation followed by a new upgrading of the CRT for persistent FMR at the follow-up. The optimization of the interventricular delay, guided by echocardiographic parameters, resulted in a significant clinical and functional benefit. Echo-guided CRT upgrading can provide additive efficacy for patients in whom MitraClip implantation does not significantly improve FMR and symptoms.
authors.affiliation: Department of Cardiovascular Disease, Tor Vergata University of Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Versaci
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Vizzari
authors.affiliation: Department of Cardiovascular Disease, Tor Vergata University of Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Sergi
authors.affiliation: Department of Cardiology, "A. Cardarelli" Hospital, Campobasso, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Trivisonno
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Andò
authors.affiliation: Department of Cardiology, "Pineta Grande" Hospital, Castelvolturno (CE), Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Nardi
authors.affiliation: Department of Cardiovascular Disease, Tor Vergata University of Rome, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ussia
authors.affiliation: Department of Cardiovascular Disease, Tor Vergata University of Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods; D004452:Echocardiography / Q000379:methods; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000628:therapy*; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology; D020257:Ventricular Remodeling / Q000502:physiology*
keywords: Cardiac resynchronization therapy; Functional mitral regurgitation; Heart failure; MitraClip