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Yeo KK, Ding ZP, Chua YL, Lim ST, Sin KY, Tan WC, Chiam PT, Hwang NC, Koh TH
Correspondence: Dr Yeo Khung Keong, yeo.khung.keong@nhcs.com.sg
ABSTRACT
A 67-year-old Chinese woman with comorbidities of chronic obstructive lung disease, hypertension and prior coronary artery bypass surgery presented with severe functional mitral regurgitation (MR) and severely depressed left ventricular function. She was in New York Heart Association (NYHA) Class II–III. Due to high surgical risk, she was referred for percutaneous treatment with the MitraClip valve repair system. This procedure is typically performed via the femoral venous system and involves a transseptal puncture. A clip is delivered to grasp the regurgitant mitral valve leaflets and reduce MR. This was performed uneventfully in our patient, with reduction of MR from 4+ to 1+. She was discharged on post-procedure Day 2 and her NYHA class improved to Class I. This was the first successful MitraClip procedure performed in Asia and represents a valuable treatment option in patients with severe MR, especially those with functional MR or those at high surgical risk.
Keywords: heart failure, minimally invasive, mitral regurgitation
Singapore Med J 2013; 54:e9-e12; http://dx.doi.org/10.11622/smedj.2013017
REFERENCES
| 1. Feldman T, Kar S, Rinaldi M, et al. Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort. J Am Coll Cardiol 2009; 54:686-94. http://dx.doi.org/10.1016/j.jacc.2009.03.077 | ||||
| 2. Feldman T, Wasserman HS, Herrmann HC, et al. Percutaneous mitral valve repair using the edge-to-edge technique: six-month results of the EVEREST Phase I Clinical Trial. J Am Coll Cardiol 2005; 46:2134-40. http://dx.doi.org/10.1016/j.jacc.2005.07.065 | ||||
| 3. Franzen O, Baldus S, Rudolph V, et al. Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction. Eur Heart J 2010; 31:1373-81. http://dx.doi.org/10.1093/eurheartj/ehq050 | ||||
| 4. Feldman T, Foster E, Glower DD, et al. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med 2011; 364:1395-406. http://dx.doi.org/10.1056/NEJMoa1009355 | ||||
| 5. Alfieri O, Maisano F. An effective technique to correct anterior mitral leaflet prolapse. J Card Surg 1999; 14:468-70. http://dx.doi.org/10.1111/j.1540-8191.1999.tb01280.x | ||||
| 6. Fucci C, Sandrelli L, Pardini A, et al. Improved results with mitral valve repair using new surgical techniques. Eur J Cardiothorac Surg 1995; 9:621-6. http://dx.doi.org/10.1016/S1010-7940(05)80107-1 | ||||
| 7. Maisano F, Torracca L, Oppizzi M, et al. The edge-to-edge technique: a simplified method to correct mitral insufficiency. Eur J Cardiothorac Surg 1998; 13:240-5. http://dx.doi.org/10.1016/S1010-7940(98)00014-1 | ||||
| 8. Franzen O, Baldus S, Rudolph V, et al. Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction. Eur Heart J 2010; 31:1373-81. http://dx.doi.org/10.1093/eurheartj/ehq050 | ||||
| 9. Tamburino C, Ussia GP, Maisano F, et al. Percutaneous mitral valve repair with the MitraClip system: acute results from a real world setting. Eur Heart J 2010; 31:1382-9. http://dx.doi.org/10.1093/eurheartj/ehq051 | ||||
| 10.Bishay ES, McCarthy PM, Cosgrove DM, et al. Mitral valve surgery in patients with severe left ventricular dysfunction. Eur J Cardiothorac Surg 2000; 17:213-21. http://dx.doi.org/10.1016/S1010-7940(00)00345-6 | ||||
| 11. Di Salvo TG, Acker MA, Dec GW, Byrne JG. Mitral valve surgery in advanced heart failure. J Am Coll Cardiol 2010; 55:271-82. http://dx.doi.org/10.1016/j.jacc.2009.08.059 | ||||
| 12.Kapoor JR. Role of mitral valve surgery for secondary mitral regurgitation in heart failure. J Am Coll Cardiol 2009; 53:74. http://dx.doi.org/10.1016/j.jacc.2008.08.065 | ||||
| 13.Wu AH, Aaronson KD, Bolling SF, et al. Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction. J Am Coll Cardiol 2005; 45:381-7. http://dx.doi.org/10.1016/j.jacc.2004.09.073 | ||||