Key result
The MitraClip procedure successfully reduced acute mitral regurgitation from severe to mild-moderate and resolved unilateral left-sided pulmonary edema in a high-risk patient with STEMI.
Case Report (n=1)
No
Transcatheter edge-to-edge repair can be a safe and effective alternative for high-surgical-risk patients presenting with acute severe mitral regurgitation and unilateral pulmonary edema complicating STEMI.
MitraClip may be feasible as bailout in unstable post-MI severe MR when surgery is contraindicated; hypothesis-generating, needs prospective trials.
A 67-year-old man with inferior wall ST-segment elevation myocardial infarction underwent Impella-assisted percutaneous coronary intervention complicated by unilateral left-sided pulmonary edema and cardiogenic shock due to severe mitral valve regurgitation. Surgery was deferred due to hemodynamic instability and a high risk of mortality, so he underwent a MitraClip procedure. Mitral regurgitation (MR) is a catastrophic mechanical complication of myocardial infarction that leads to the development of pulmonary edema, cardiogenic shock, and death. After the procedure, the patient significantly reduces MR with a resolution of pulmonary edema. Acute MR can rarely present as a unilateral left-sided pulmonary edema delaying diagnosis and treatment. Transcatheter edge-to-edge repair can be a safe alternative for patients who are at high risk for surgery.
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Anjum et al. (2023) conducted a case report in Acute mitral regurgitation with unilateral left-sided pulmonary edema complicating STEMI (n=1). MitraClip procedure was evaluated on Reduction in mitral regurgitation severity. The MitraClip procedure successfully reduced acute mitral regurgitation from severe to mild-moderate and resolved unilateral left-sided pulmonary edema in a high-risk patient with STEMI.
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