经导管缘对缘修复术治疗心肌梗死后乳头肌断裂所致急性二尖瓣反流
Transcatheter Edge-to-Edge Repair for Acute Mitral Regurgitation due to Postinfarction Papillary Muscle Rupture.
作者信息
Chang Chih-Wei, Romero Steven, Price Matthew J
机构信息
Division of Cardiology, Scripps Clinic, San Diego, California.
出版信息
J Soc Cardiovasc Angiogr Interv. 2022 Aug 9;1(5):100431. doi: 10.1016/j.jscai.2022.100431. eCollection 2022 Sep-Oct.
BACKGROUND
Early case reports have suggested that transcatheter edge-to-edge repair (TEER) with the MitraClip for the treatment of acute mitral regurgitation (MR) due to post-infarction papillary muscle rupture (PMR) may be an alternative for patients at prohibitive surgical risk. However, data on consecutive patients treated for this condition is lacking.
METHODS
To define the procedural characteristics, medication use, hemodynamic parameters, and imaging data, we present 5 consecutive patients with acute MR from postinfarction PMR treated with TEER at Scripps Memorial Hospital La Jolla between June 2018 and November 2020.
RESULTS
Successful reduction of MR and improved hemodynamics were achieved in all cases. Despite the procedural success, only 1 of the 5 patients survived until hospital discharge.
CONCLUSION
TEER may be an effective treatment for acute MR due to postinfarction PMR to reduce MR and improve hemodynamics. Survival to discharge was infrequent, suggesting that TEER may be appropriate only in selected patients.
背景
早期病例报告表明，使用MitraClip进行经导管缘对缘修复（TEER）治疗心肌梗死后乳头肌破裂（PMR）所致的急性二尖瓣反流（MR），对于手术风险极高的患者可能是一种替代方案。然而，缺乏关于连续治疗此类患者的数据。
方法
为了明确手术特征、药物使用、血流动力学参数和影像学数据，我们呈现了2018年6月至2020年11月期间在拉霍亚scripps纪念医院接受TEER治疗的5例因心肌梗死后PMR导致急性MR的连续患者。
结果
所有病例均成功降低了MR并改善了血流动力学。尽管手术成功，但5例患者中只有1例存活至出院。
结论
TEER可能是治疗心肌梗死后PMR所致急性MR以降低MR和改善血流动力学的有效方法。出院存活率较低，表明TEER可能仅适用于特定患者。
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