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对于早期复发性二尖瓣反流,重复使用 MitraClip。

Repeat MitraClip for early recurrent mitral regurgitation.

机构信息

Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.

Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.

出版信息

Catheter Cardiovasc Interv. 2018 Sep 1;92(3):611-616. doi: 10.1002/ccd.27460. Epub 2017 Dec 27.

Abstract

Treatment for recurrent mitral regurgitation (MR) after MitraClip therapy remains a challenging issue. This study reports the efficacy of repeat MitraClip therapy for recurrent MR during the early phase after the index MitraClip procedure. We present a case series of four consecutive patients who underwent repeat MitraClip procedures for severe recurrent MR during the early phase. Partial clip detachment (PCD) was the suspected cause of recurrent MR in these cases. All patients received additional clip(s). PCD could be stabilized and MR grade improved in all cases compared with that before the second procedure. Repeat MitraClip procedures for recurrent MR due to PCD are feasible during the early phase. However, patients having PCD with paracommissural MR may not be good candidates for repeat MitraClip.

摘要

经导管二尖瓣夹合术(MitraClip)治疗二尖瓣反流(MR)后复发仍然是一个棘手的问题。本研究报告了在指数 MitraClip 手术后早期重复 MitraClip 治疗复发 MR 的疗效。我们报告了 4 例连续患者的病例系列,这些患者在早期阶段因严重复发的 MR 而接受重复 MitraClip 手术。在这些病例中,部分夹脱离(PCD)被怀疑是复发 MR 的原因。与第二次手术前相比,所有患者均接受了额外的夹子。在所有病例中,PCD 均得到稳定,MR 分级得到改善。对于因 PCD 引起的复发 MR,早期重复 MitraClip 手术是可行的。然而,对于具有副间隔 MR 的 PCD 患者,重复 MitraClip 可能不是一个好的选择。

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