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Case Reports
. 2018 Feb;5(1):201-203.
doi: 10.1002/ehf2.12247. Epub 2018 Jan 18.

Catheter-based edge-to-edge mitral valve repair for pulmonary pressure reduction and to postpone heart transplantation in a teenaged patient

Moritz Messner  1 , Florian Hintringer  1 , Silvana Müller  1 , Marc Michael Zaruba  1 , Nikolaos Bonaros  2 , Herwig Antretter  2 , Daniel Basic  1 , Gerhard Pölzl  1
Affiliations
Case Reports

Catheter-based edge-to-edge mitral valve repair for pulmonary pressure reduction and to postpone heart transplantation in a teenaged patient

Moritz Messner et al. ESC Heart Fail. 2018 Feb.

Abstract

We report a case of catheter-based edge-to-edge mitral valve repair in a teenage male patient with non-ischaemic cardiomyopathy to improve pulmonary hypertension secondary to severe functional mitral regurgitation (FMR) to defer anticipated heart transplantation. A 19-year-old patient with previous history of fulminant myocarditis followed by markedly left ventricular dysfunction presented with severe mitral regurgitation 3 years after initial recovery. Slightly over time, deterioration of FMR was associated with gradual increase in pulmonary artery pressures despite optimal medical therapy. MitraClip implantation in this young patient was successfully performed with sustainable improvement of pulmonary hypertension.

Keywords: MitraClip; Mitral valve regurgitation; Myocarditis; Pulmonary hypertension.

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Figures

Figure 1
Figure 1
Transoesophageal echocardiography shows reduction of functional mitral regurgitation from severe (A) to mild (B) with successful implantation of three MitraClips. Antegrade gradient across the mitral valve was 2 mmHg.
Figure 2
Figure 2
Pre‐interventional resting haemodynamics, pulmonary artery (PA) pressure and pulmonary capillary wedge (PCW) pressure (A) significantly improved after MitraClip implantation with sustained effects at 1 year follow‐up (B). In parallel, cardiac output increased from 2.8 to 3.6 L/min.
See this image and copyright information in PMC

References

    1. Kottenberg E, Dumont M, Frey UH, Heine T, Plicht B, Kahlert P, Erbel R, Peters J. The minimally invasive MitraClip procedure for mitral regurgitation under general anaesthesia: immediate effects on the pulmonary circulation and right ventricular function. Anaesthesia 2014; 69: 860–867. - PubMed
    1. Garatti A, Castelvecchio S, Bandera F, Medda M, Menicanti L. MitraClip procedure as a bridge therapy in a patient with heart failure listed for heart transplantation. Ann Thorac Surg 2015; 99: 1796–1799. - PubMed

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