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二尖瓣经导管缘对缘修复术与经导管闭合二尖瓣前叶穿孔同期进行

Concomitant Mitral Transcatheter Edge-to-Edge Repair and Transcatheter Closure of Perforated Anterior Mitral Valve Leaflet.

作者信息

Prakash Shriya K, Andreas Caitlyn, Kharsa Chloe, Sella Gal, Teng Catherine, Sherwani Kamran, Rawasia Wasiq F, Del Val Fernando Ramirez, Little Stephen H, Goel Sachin S

机构信息

Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.

Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.

出版信息

JACC Case Rep. 2025 May 7;30(9):103749. doi: 10.1016/j.jaccas.2025.103749. Epub 2025 Apr 9.

DOI:10.1016/j.jaccas.2025.103749
PMID:40208142
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12245431/
Abstract

We present the case of a 76-year-old man with a previous history of surgical aortic valve replacement 3 years earlier for infective endocarditis, nonischemic cardiomyopathy, and severe secondary mitral regurgitation (SMR) who presented with worsening dyspnea on exertion. Echocardiography revealed severe SMR and a perforation at the base of the A1 scallop of the anterior mitral valve leaflet (AMVL). The patient was deemed at high surgical risk. After multidisciplinary team discussion, we proceeded with mitral transcatheter edge to edge repair with 2 MitraClips (Abbott) and concomitant transcatheter closure of the perforation of the AMVL with an Amplatzer Duct Occluder II (Abbott) device.

摘要

我们报告一例76岁男性患者，其3年前因感染性心内膜炎、非缺血性心肌病和严重继发性二尖瓣反流（SMR）接受了主动脉瓣置换手术，此次因劳力性呼吸困难加重前来就诊。超声心动图显示严重SMR以及二尖瓣前叶（AMVL）A1扇贝形瓣叶基部穿孔。该患者被认为手术风险高。经过多学科团队讨论，我们使用2个MitraClip（雅培公司）进行二尖瓣经导管缘对缘修复，并同时使用Amplatzer Duct Occluder II（雅培公司）装置经导管封闭AMVL穿孔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a5/12245431/e8fb2db4de45/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a5/12245431/7e9a584b9497/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a5/12245431/9677be52bec4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a5/12245431/e8fb2db4de45/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a5/12245431/7e9a584b9497/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a5/12245431/9677be52bec4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a5/12245431/e8fb2db4de45/gr2.jpg

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本文引用的文献

1
Plug and Clip: Percutaneous Repair of a Perforated Mitral Valve Complicating Severe Functional Mitral Regurgitation.
JACC Cardiovasc Interv. 2022 Feb 28;15(4):e41-e43. doi: 10.1016/j.jcin.2021.12.009. Epub 2022 Jan 31.
2
Percutaneous Repair of Mitral Valve Leaflet Perforation.经皮二尖瓣叶穿孔修复术
JACC Cardiovasc Interv. 2019 Jan 28;12(2):210-213. doi: 10.1016/j.jcin.2018.11.043. Epub 2018 Dec 26.