Department of Cardiology and Angiology, University Hospital, Eberhard Karls University Tuebingen, Tuebingen, Germany.
Hospital Ostalb gkAöR, Aalen, Germany.
Am J Case Rep. 2021 Jan 18;22:e928089. doi: 10.12659/AJCR.928089.
BACKGROUND Severe tricuspid valve regurgitation (TR) is associated with high cardiovascular mortality. Safe and feasible interventional approaches to treat severe TR are of clinical relevance. The MitraClip is a device that has been approved by the US Food and Drug Administration (FDA) for the repair of mitral valve lesions. Percutaneous femoral venous access with fluoroscopic and echocardiographic guidance is used to deliver a cobalt-chromium clip to secure the mitral valve leaflets. We report on an 85-year-old man with tricuspid valve regurgitation who underwent percutaneous edge-to-edge tricuspid valve leaflet plication with the new, advanced MitraClip XTR System. CASE REPORT An 85-year-old man with severe TR due to annulus dilation of the right ventricle and short septal leaflet presented repeatedly at our hospital with severe right heart failure symptoms. Transesophageal echocardiography revealed severe TR with a large coaptation gap size of 10.6 mm. Percutaneous edge-to-edge valve repair with the new-generation MitraClip System XTR with wider clip arms could overcome the large coaptation gap. We achieved a strong reduction of TR after deploying 2 MitraClips XTR. The patient recovered quickly and has not been admitted to hospital due to heart failure symptoms since the intervention for more than 6 months. CONCLUSIONS Previous studies have shown the safety and effectiveness of the MitraClip device and supported FDA approval for tricuspid valve repair. This report of a patient with complex tricuspid regurgitation demonstrated the feasible use of the new MitraClip XTR System, which improved edge-to-edge tricuspid valve repair due to its increased span and improved grip.
严重三尖瓣反流（TR）与心血管死亡率高有关。安全可行的介入治疗方法来治疗严重 TR 具有临床相关性。MitraClip 是一种已被美国食品和药物管理局（FDA）批准用于修复二尖瓣病变的装置。经股静脉入路，在荧光透视和超声心动图引导下，将钴铬夹输送到二尖瓣叶以固定二尖瓣叶。我们报告了一位 85 岁男性，因右心室瓣环扩张和短隔瓣导致三尖瓣反流，因严重右心衰竭症状多次在我院就诊。经食管超声心动图显示严重 TR，瓣环对合间隙大 10.6mm。使用新一代 MitraClip XTR 系统进行经皮缘对缘三尖瓣瓣叶折叠术可克服大瓣环对合间隙。我们使用 2 个 MitraClip XTR 实现了 TR 的明显减少。患者恢复迅速，自介入治疗 6 个多月以来，因心力衰竭症状未再住院。结论：先前的研究表明 MitraClip 装置的安全性和有效性，并支持 FDA 批准用于三尖瓣修复。本报告中一位复杂三尖瓣反流患者的病例展示了新型 MitraClip XTR 系统的可行性应用，由于其增加的跨度和改善的抓握能力，改善了缘对缘三尖瓣修复。
