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经导管缘对缘二尖瓣修复术降低肺动脉压并推迟青少年患者心脏移植

Catheter-based edge-to-edge mitral valve repair for pulmonary pressure reduction and to postpone heart transplantation in a teenaged patient.

机构信息

Clinical Division of Cardiology and Angiology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.

Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria.

出版信息

ESC Heart Fail. 2018 Feb;5(1):201-203. doi: 10.1002/ehf2.12247. Epub 2018 Jan 18.

DOI:10.1002/ehf2.12247
PMID:29345417
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5793970/
Abstract

We report a case of catheter-based edge-to-edge mitral valve repair in a teenage male patient with non-ischaemic cardiomyopathy to improve pulmonary hypertension secondary to severe functional mitral regurgitation (FMR) to defer anticipated heart transplantation. A 19-year-old patient with previous history of fulminant myocarditis followed by markedly left ventricular dysfunction presented with severe mitral regurgitation 3 years after initial recovery. Slightly over time, deterioration of FMR was associated with gradual increase in pulmonary artery pressures despite optimal medical therapy. MitraClip implantation in this young patient was successfully performed with sustainable improvement of pulmonary hypertension.

摘要

我们报告了一例经导管二尖瓣瓣环成形术治疗非缺血性心肌病患者的病例，该患者因严重功能性二尖瓣反流（FMR）导致肺动脉高压，需要进行二尖瓣瓣环成形术以推迟预期的心脏移植。该患者为 19 岁男性，既往有暴发性心肌炎病史，随后左心室功能明显下降，在最初恢复 3 年后出现严重二尖瓣反流。随着时间的推移，尽管进行了最佳的药物治疗，FMR 的恶化仍与肺动脉压的逐渐升高相关。在该年轻患者中成功进行了二尖瓣夹合术，肺动脉高压得到了持续改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/5793970/ec5d105202a0/EHF2-5-201-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/5793970/65f440e61d0d/EHF2-5-201-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/5793970/ec5d105202a0/EHF2-5-201-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/5793970/65f440e61d0d/EHF2-5-201-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/5793970/ec5d105202a0/EHF2-5-201-g002.jpg

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本文引用的文献

1
Mitraclip procedure as a bridge therapy in a patient with heart failure listed for heart transplantation.
Ann Thorac Surg. 2015 May;99(5):1796-9. doi: 10.1016/j.athoracsur.2014.07.079.
2
The minimally invasive MitraClip™ procedure for mitral regurgitation under general anaesthesia: immediate effects on the pulmonary circulation and right ventricular function.在全身麻醉下进行经皮二尖瓣钳夹术治疗二尖瓣反流：对肺循环和右心室功能的即刻影响。
Anaesthesia. 2014 Aug;69(8):860-7. doi: 10.1111/anae.12712. Epub 2014 May 7.