Perkutane Mitralklappenrekonstruktion bei schwerer Mitralinsuffizienz nach Mitralklappenannuloplastie: MitraClip-in-the-ring als ergänzende Strategie

Translated title of the contribution: Percutaneous mitral valve repair in recurrent severe mitral valve regurgitation after mitral annuloplasty: MitraClip-in-the-ring as a complementary strategy

Sven T. Pleger, Nicolas Geis, Michael Kreusser, Haitham Abu-Sharar, Christian Sebening, Gabor Szabo, Hugo A. Katus, Philip W.J. Raake

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Patients with reduced left ventricular (LV) function undergoing coronary artery bypass graft surgery or/and aortic valve replacement occasionally show severe mitral valve (MV) regurgitation and thus also undergo surgical mitral annuloplasty. Over time, further deterioration of LV function and additional ischemic events cause recurrence of severe MV regurgitation due to the Carpentier IIIb morphology of the MV that is not adequately addressed by the previously implanted annuloplasty ring. Methods: Seven patients (Society of Thoracic Surgeons score: 7.5 ± 1.5%) with Carpentier type-IIIb recurrent severe MV regurgitation, having undergone prior cardiothoracic surgery (median: 40 months) including mitral annuloplasty, were treated with the MitraClip device. Results: MitraClip implantation resulted in significantly reduced MV regurgitation and improved New York Heart Association functional state, translating into an increased exercise capability and improved cardiac biomarkers. The morphology of the MV was adequately addressed without causing relevant MV stenosis, while the MV annulus area remained unaltered. The procedure was safe with a 30-day mortality rate of 0%. Conclusion: MitraClip-in-the-ring is feasible and in principle safe for treating Carpentier type IIIb severe MV regurgitation after surgical MV repair using mitral annuloplasty. MitraClip-in-the-ring resulted in immediate amelioration of clinical symptoms and increased physical exercise capacity.

Translated title of the contributionPercutaneous mitral valve repair in recurrent severe mitral valve regurgitation after mitral annuloplasty: MitraClip-in-the-ring as a complementary strategy
Original languageGerman
JournalHerz
DOIs
Publication statusAccepted/In press - 2019

Keywords

  • Exercise
  • Heart valve prosthesis
  • Mitral valve insufficiency
  • Mitral valve stenosis
  • Ventricular function, left

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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