Versaci Francesco, Vizzari Giampiero, Sergi Domenico, Trivisonno Antonio, Andò Giuseppe, Nardi Stefano, Ussia Gian Paolo, Romeo Francesco
Department of Cardiovascular Disease, Tor Vergata University of Rome, Italy.
Department of Clinical and Experimental Medicine, University of Messina, Italy.
Cardiovasc Revasc Med. 2017 Sep;18(6S1):26-29. doi: 10.1016/j.carrev.2017.01.006. Epub 2017 Jan 17.
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.
对于部分患有退行性或功能性二尖瓣反流（FMR）的患者，已提出采用二尖瓣夹合术作为一种治疗选择，该疗法具有临床及预后益处。既往研究证实，二尖瓣夹合术对心脏再同步治疗（CRT）无反应的患者在症状及左心室重构方面具有安全性及有效性。我们报告了1例CRT无反应患者，接受二尖瓣夹合植入术治疗，随访时因持续性FMR接受了CRT的再次升级。在超声心动图参数的指导下优化心室间延迟，带来了显著的临床及功能改善。对于二尖瓣夹合植入术未能显著改善FMR及症状的患者，超声引导下的CRT升级可提供额外疗效。
