MitraClip in patients with difficult weaning in the context of severe mitral regurgitation and cardiogenic shock
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Abstract
Mitral regurgitation (MR) due to severe left ventricular dysfunction wornsens the prognosis of patients with heart failure who need admission to Intensive Care Units. The percutaneous mitral valve repair with MitraClip is a therapy indicated in chronic patients with high surgical risk, however, its role has not been established in acute patients.
We present two cases of patients admitted to our unit for cardiogenic shock who presented difficult weaning from invasive mechanical ventilation due to MR refractory to medical treatment. Both patients presented high surgical risk, so percutaneous treatment was chosen with good short-term results, allowing the disconnection of mechanical ventilation in the following days.
MitraClip implantation is a safe therapy in the treatment of severe secondary MR in patients with cardiogenic shock who present high surgical risk, with good results in the early stage.
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References
Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC [published correction appears in Eur Heart J. 2016 Dec 30;:]. Eur Heart J. 2016;37(27):2129-2200. doi: 10.1093/eurheartj/ehw128
Baumgartner, H., Falk, V., Bax, J. J., De Bonis, M., Hamm, C., Holm, P. J., et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. In European Heart Journal 2017; 38 (36): 2739–2791 https://doi.org/10.1093/eurheartj/ehx391
Rudolph V, Huntgeburth M, von Bardeleben RS, et al. Clinical outcome of critically ill, not fully recompensated, patients undergoing MitraClip therapy. Eur J Heart Fail. 2014;16(11):1223-1229. doi:10.1002/ejhf.169
Turyan Medvedovsky, A., Tonchev, I., Tahiroglu, I., Lotan, C., Gilon, D., Planer, et al. MitraClip Therapy in Critically Ill Patients with Severe Functional Mitral Regurgitation and Refractory Heart Failure. Structural Heart,2019; 3(4), 296–301. https://doi.org/10.1080/24748706.2019.1618514
Estévez-Loureiro, R., Adamo, M., Arzamendi, D., Denti, P., Freixa, X., Nombela-Franco, L., … Fernández, F. (2020). Transcatheter mitral valve repair in patients with acute myocardial infarction: Insights from the European Registry of MitraClip in Acute Mitral Regurgitation following an acute myocardial infarction (EREMMI). EuroIntervention, 15(14), 1248–1250. https://doi.org/10.4244/EIJ-D-19-00653
Mendirichaga R, Singh V, Blumer V, et al. Transcatheter Mitral Valve Repair With MitraClip for Symptomatic Functional Mitral Valve Regurgitation. Am J Cardiol. 2017;120(4):708-715. doi: 10.1016/j.amjcard.2017.05.041
Pascual I, Arzamendi D, Carrasco-Chinchilla F, et al. Transcatheter mitral repair according to the cause of mitral regurgitation: real-life data from the Spanish MitraClip registry. Rev Esp Cardiol (Engl Ed). 2020;73(8):643-651. doi:10.1016/j.rec.2019.07.018.
Garcia S, Alsidawi S, Bae R, et al. Percutaneous Mitral Valve Repair With MitraClip in Inoperable Patients With Severe Mitral Regurgitation Complicated by Cardiogenic Shock. J Invasive Cardiol. 2020;32(6):228-231.