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经导管二尖瓣修复术成功后再次行经导管三尖瓣修复术 1 例:新情况需要新答案。

A Case of Catheter-Based Tricuspid Valve Repair Reversing the Previous Success of Transcatheter Mitral Valve Repair: A New Scenario Requires New Answers.

机构信息

Cardiovascular Department, GVM Care & Research, Maria Cecilia Hospital, Cotignola-Ravenna, Italy.

Cardiovascular Department, GVM Care & Research, Maria Cecilia Hospital, Cotignola-Ravenna, Italy.

出版信息

Can J Cardiol. 2022 Jan;38(1):123-125. doi: 10.1016/j.cjca.2021.09.024. Epub 2021 Oct 2.

Abstract

Concomitant severe mitral-tricuspid regurgitation is observed in up to 30% of patients with reduced left ventricular ejection fraction. In symptomatic subjects at high surgical risk, transcatheter treatment is a viable option in the presence of suitable anatomy. We present a case of mitral regurgitation worsening after TriClip (Abbott, Abbott Park, IL) implantation in a patient with a previous successful MitraClip (Abbott) intervention. The correction of tricuspid regurgitation by catheter repair improves overall hemodynamics, but it can sometimes paradoxically worsen mitral regurgitation, as herein displayed. Clinical care is needed to detect tricuspid regurgitation repair-induced worsening of mitral regurgitation and ensure optimal management.

摘要

伴有严重二尖瓣三尖瓣反流在左心室射血分数降低的患者中高达 30%。对于手术风险高的有症状患者,在合适的解剖结构存在的情况下,经导管治疗是一种可行的选择。我们报告了一例在先前成功行 MitraClip(雅培,雅培公园,IL)介入治疗的患者中,TriClip(雅培)植入后二尖瓣反流加重的病例。导管修复纠正三尖瓣反流可改善整体血液动力学,但有时会如本文所示,反而使二尖瓣反流恶化。需要临床护理来检测三尖瓣反流修复引起的二尖瓣反流恶化,并确保最佳管理。

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