Abstract
Acute mitral regurgitation is a heterogeneous and life-threatening pathology, with severe hemodynamic consequences and extremely adverse outcomes. Traditionally, the definitive treatment is prompt surgical intervention after hemodynamic stabilization. Nowadays, however, percutaneous repair of mitral valve with MitraClip device has emerged as a safe and effective therapeutic option. Evidences in this field are still scarce. Hereby, we report the case of an 82-year-old woman with lateral ST-elevation myocardial infarction determining severe acute mitral regurgitation (MR) with an asymmetric leaflet tethering mechanism. Due to prohibitive operative risk and unstable hemodynamic status, the patient underwent a successful urgent MitraClip procedure with optimal reduction of MR and immediate hemodynamic improvement. Moreover, we provide a review of the available literature regarding the echocardiographic assessment of acute MR, results of published cases and possible management of this complex pathology.
Highlights
Percutaneous repair of mitral regurgitation (MR) with the MitraClip device (Abbott Vascular, Abbott Park, Illinois, USA) is an established therapeutic option for patients with prohibitive surgical risk and anatomically suitable mitral valve (MV)[1]
While the impact of percutaneous MV repair on outcomes in chronic severe symptomatic MR has been evaluated for years in detail, data regarding the use of percutaneous edge-to-edge procedure in patients with severe acute MR are scarce and limited to case reports or small-size registries
We present a case of acute severe ischemic mitral regurgitation successfully treated with MitraClip procedure
Summary
Percutaneous repair of mitral regurgitation (MR) with the MitraClip device (Abbott Vascular, Abbott Park, Illinois, USA) is an established therapeutic option for patients with prohibitive surgical risk and anatomically suitable mitral valve (MV)[1]. While the impact of percutaneous MV repair on outcomes in chronic severe symptomatic MR has been evaluated for years in detail, data regarding the use of percutaneous edge-to-edge procedure in patients with severe acute MR are scarce and limited to case reports or small-size registries. Acute MR is a complex and heterogeneous pathology, with severe hemodynamic consequences and extremely adverse outcomes[2]. In most cases, after hemodynamic stabilization, the definitive treatment is surgical intervention. The MitraClip device is proving to be a valuable therapeutic option in high-risk patients
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