Transcatheter Procedure for Residual Mitral Regurgitation After MitraClip Implantation Using Amplatzer Duct Occluder II
| Autor: | Shunsuke Kubo, Asma Hussaini, Tarun Chakravarty, Saibal Kar, Moody Makar, Yoshifumi Nakajima, Emily Tat, Justin Cox, Abhimanyu Uberoi, Yukiko Mizutani |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty Time Factors Septal Occluder Device Echocardiography Three-Dimensional 030204 cardiovascular system & hematology Prosthesis Design Radiography Interventional Severity of Illness Index New york heart association 03 medical and health sciences 0302 clinical medicine medicine.artery Humans Medicine 030212 general & internal medicine Aged Aged 80 and over Heart Valve Prosthesis Implantation Mitral regurgitation business.industry MitraClip Hemodynamics Mitral Valve Insufficiency Treatment options Mean age Echocardiography Doppler Color Surgery Left atrial pressure Treatment Outcome Heart Valve Prosthesis Right coronary artery Retreatment Device Embolization Mitral Valve Female Radiology Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal |
| Zdroj: | JACC: Cardiovascular Interventions. 9:1280-1288 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2016.03.011 |
| Popis: | Objectives This study reports a novel transcatheter procedure for residual mitral regurgitation (MR) after MitraClip implantation using the Amplatzer Duct Occluder II (ADO II). Background Although the MitraClip procedure is a transcatheter treatment option for patients at high surgical risk with severe MR, management of significant residual MR after MitraClip implantation is still challenging. Methods We describe a case series of 9 consecutive patients who underwent transcatheter deployment of the ADO II plug for significant residual MR after MitraClip implantation from April to October 2015. Results The mean age was 79.3 ± 11.4 years. The deployment of the ADO II plug was performed at the initial MitraClip procedure in 7 patients and at the second procedure for recurrent symptoms in 2 patients. There were 2 types of residual MR seen after MitraClip implantation: residual commissural MR (n = 3) and residual intraclip MR (n = 6). The ADO II was successfully deployed with significant reduction of MR flow and left atrial pressure in all patients. The ADO II plug was retrieved in 1 patient because of device embolization to the ostial right coronary artery. However, all patients were discharged 1.8 ± 1.2 days after the procedure, with no significant MR on pre-discharge transthoracic echocardiography. In 8 patients who underwent 1-month symptomatic assessment, clinical symptoms were diminished to New York Heart Association functional class I or II. Conclusions Transcatheter deployment of the ADO II plug was effective for the reduction of residual commissural MR and intraclip MR after MitraClip implantation. The potential role of this technique should be established for challenging cases. |
| Databáze: | OpenAIRE |
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