Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Division of Cardiology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
Division of Cardiothoracic Intensive Care, ASST Spedali Civili di Brescia, Brescia, Italy.
Catheter Cardiovasc Interv. 2023 Jul;102(1):138-144. doi: 10.1002/ccd.30682. Epub 2023 May 10.
Papillary muscle rupture (PMR) is a rare complication of acute myocardial infarction (AMI) associated with high mortality and morbidity. Surgery is the gold-standard treatment for these patients, but it is burdened by a high perioperative risk due to hemodynamic instability. Mitral transcatheter edge-to-edge repair (M-TEER) was reported to be safe and effective in unstable patients with significant mitral regurgitation. However, data in patients with post-AMI PMR are limited to a few case reports. In this review, we summarized all data available regarding percutaneous treatment of post-AMI PMR. These results show that M-TEER is safe and effective in this setting with low in-hospital mortality and complications and high rate of significant mitral regurgitation reduction.
乳头肌破裂（PMR）是急性心肌梗死（AMI）的罕见并发症，与高死亡率和高发病率相关。对于这些患者，手术是金标准治疗方法，但由于血流动力学不稳定，手术围术期风险较高。二尖瓣经导管缘对缘修复术（M-TEER）已被报道在有明显二尖瓣反流的不稳定患者中是安全有效的。然而，AMI 后 PMR 患者的数据仅限于少数病例报告。在这篇综述中，我们总结了所有关于经皮治疗 AMI 后 PMR 的可用数据。这些结果表明，M-TEER 在这种情况下是安全有效的，院内死亡率和并发症低，显著二尖瓣反流减少率高。
