Why the study?
Severe pulmonary hypertension and elevated pulmonary vascular resistance preclude end-stage heart failure patients from heart transplantation, which may be exacerbated by functional severe mitral regurgitation in conditions like Chagasic cardiomyopathy.
Does MitraClip reduce severe pulmonary hypertension in a patient with end-stage Chagas cardiomyopathy and severe functional mitral regurgitation to allow heart transplantation?
Does MitraClip reduce severe pulmonary hypertension in a patient with end-stage Chagas cardiomyopathy and severe functional mitral regurgitation to allow heart transplantation?
MitraClip may serve as an effective bridging strategy to reduce severe pulmonary hypertension and enable heart transplantation in patients with end-stage Chagas cardiomyopathy and severe functional mitral regurgitation.
Supports consideration of MR correction for transplant eligibility in Chagasic cardiomyopathy with severe PH; hypothesis-generating, needs prospective validation.
BACKGROUND: Patients with end-stage heart failure, suffering from severe pulmonary hypertension (PH) and elevated pulmonary vascular resistance, are not eligible for heart transplant due to high mortality risk and primary graft dysfunction. Severe PH may be favoured by functional severe mitral regurgitation, which is present in many cardiopathies like end-stage Chagasic cardiomyopathy. CASE SUMMARY: We present a case of a young man with end-stage heart failure secondary to Chagas cardiomyopathy with severe functional mitral regurgitation (FMR) and severe PH. The patient received percutaneous correction with MitraClip® system reducing PH and making him a suitable candidate for heart transplant. DISCUSSION: therapy appears to be safe and effective for control of severe PH as a bridge measure for cardiac transplantation.
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Vásquez et al. (2020) studied this question.
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