使用MitraClip系统并联合Impella机械循环支持进行经导管缘对缘修复的病例系列报道。
Case series of transcatherter edge-to-edge repair using MitraClip system with Impella mechanical circulatory support.
作者信息
Tanaka Shuhei, Imamura Teruhiko, Narang Nikhil, Fukuo Atsuko, Nakamura Makiko, Fukuda Nobuyuki, Ueno Hiroshi, Kinugawa Koichiro
机构信息
Cardiovascular Center, Toyama University Hospital, Toyama, Japan.
Advocate Christ Medical Center, Oak Lawn, IL, USA.
出版信息
Eur Heart J Case Rep. 2022 Sep 7;6(9):ytac370. doi: 10.1093/ehjcr/ytac370. eCollection 2022 Sep.
BACKGROUND
Secondary mitral regurgitation (SMR) is a major comorbidity in patients with heart failure with reduced ejection fraction (HFrEF). Transcatheter edge-to-edge repair (TEER) using the MitraClip™ system is a promising tool for selected patients with SMR and HFrEF. Durable success using this system in patients who have advanced heart failure and unsuitable anatomy remains a clinical challenge.
CASE SUMMARY
Three patients aged 67-72 years with HFrEF on inotropic support successfully underwent Impella®-assisted TEER at our centre. Following the procedure, two patients were able to be weaned off inotropic support and were discharged, while one patient expired during the index hospitalization.
DISCUSSION
Impella®-assisted TEER may be a feasible strategy for patients with SMR and HFrEF with unstable haemodynamics particularly when cardiac replacement therapy is not applicable.
背景
继发性二尖瓣反流（SMR）是射血分数降低的心力衰竭（HFrEF）患者的主要合并症。使用MitraClip™系统进行经导管缘对缘修复（TEER）是治疗特定SMR和HFrEF患者的一种有前景的方法。对于晚期心力衰竭且解剖结构不适合的患者，使用该系统取得持久成功仍是一项临床挑战。
病例总结
3例年龄在67 - 72岁、接受正性肌力药物支持的HFrEF患者在我们中心成功接受了Impella®辅助TEER。术后，2例患者能够停用正性肌力药物支持并出院，而1例患者在索引住院期间死亡。
讨论
Impella®辅助TEER对于血流动力学不稳定的SMR和HFrEF患者可能是一种可行的策略，特别是在心脏替代治疗不适用时。
Zotero 插件