Why the study?
Percutaneous mitral valve repair with MitraClip has emerged as an option for acute mitral regurgitation, but evidence in this field remains scarce.
Does urgent percutaneous mitral valve repair with MitraClip improve hemodynamics and reduce mitral regurgitation in patients with severe acute MR complicating STEMI?
Does urgent percutaneous mitral valve repair with MitraClip improve hemodynamics and reduce mitral regurgitation in patients with severe acute MR complicating STEMI?
Urgent percutaneous mitral valve repair with MitraClip may be a safe and effective therapeutic option for severe acute mitral regurgitation in patients with prohibitive surgical risk.
Supports MitraClip feasibility in acute mitral regurgitation; hypothesis-generating and requires prospective trials before practice change.
Acute mitral regurgitation is a heterogeneous and life-threatening pathology, with severe hemodynamic consequences and extremely adverse outcomes. Traditionally, the definitive treatment is prompt surgical intervention after hemodynamic stabilization. Nowadays, however, percutaneous repair of mitral valve with MitraClip device has emerged as a safe and effective therapeutic option. Evidences in this field are still scarce. Hereby, we report the case of an 82-year-old woman with lateral ST-elevation myocardial infarction determining severe acute mitral regurgitation (MR) with an asymmetric leaflet tethering mechanism. Due to prohibitive operative risk and unstable hemodynamic status, the patient underwent a successful urgent MitraClip procedure with optimal reduction of MR and immediate hemodynamic improvement. Moreover, we provide a review of the available literature regarding the echocardiographic assessment of acute MR, results of published cases and possible management of this complex pathology.
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Cannata et al. (2020) studied this question.
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