Efficacy of MitraClip and continued multidisciplinary cardiac rehabilitation in preventing readmission of an older heart failure patient with severe multivalvular disease: A case report.

Autor: Ishihara K; Department of Rehabilitation, Sakakibara Heart Institute of Okayama, Okayama, Japan.; Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan.; Cardiovascular stroke Renal Project (CRP), Kobe, Japan., Izawa KP; Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan.; Cardiovascular stroke Renal Project (CRP), Kobe, Japan., Morikawa T; Department of Cardiology, Sakakibara Heart Institute of Okayama, Okayama, Japan., Hayashida A; Department of Cardiology, Sakakibara Heart Institute of Okayama, Okayama, Japan.
Jazyk: angličtina
Zdroj: Journal of cardiology cases [J Cardiol Cases] 2022 Sep 28; Vol. 27 (1), pp. 23-26. Date of Electronic Publication: 2022 Sep 28 (Print Publication: 2023).
DOI: 10.1016/j.jccase.2022.09.007
Abstrakt: The recommendations for the treatment of heart failure patients with severe multivalvular disease are not clear. We present a successful case of an older patient with heart failure and severe multivalvular disease in whom rehospitalization was prevented by a combination of MitraClip implantation (Abbott Vascular, Santa Clara, CA, USA) and continued multidisciplinary cardiac rehabilitation. An 85-year-old male patient presented with New York Heart Association (NYHA) class III severe mitral regurgitation (MR), severe aortic valve regurgitation (AR), and severe tricuspid valve regurgitation (TR). As first choice of treatment, surgical double valve replacement and tricuspid annuloplasty were considered. However, considering his age, pre-frailty condition, risks of surgery, and the desire of the patient, the heart team percutaneously implanted the MitraClip system. After implantation of one MitraClip (placed centrally on the A2/P2 scallops), the severity of the patient's MR decreased to mild from moderate-severe. He was followed up with multidisciplinary inpatient care and outpatient cardiac rehabilitation. At 1 year follow-up, he remained in stable condition at NYHA class I, and echocardiography at this time revealed moderate MR and TR and severe AR, and he has not required hospital readmission.
Learning Objective: This case report showed that a combination of MitraClip implantation (Abbott Vascular, Santa Clara, CA, USA) and continued multidisciplinary cardiac rehabilitation may be effective in preventing readmission in older patients with heart failure and severe multivalvular disease.
Competing Interests: K. I. and K.P. I. declare that there is no conflict of interest. T. M. and A. H. are speakers, consultants and proctors for Abbott Medical Japan (MitraClip) and report receiving honoraria from Abbott Medical Japan.
(© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.)
Databáze: MEDLINE
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