Key result
Placement of a central Alfieri edge-to-edge stitch eliminated severe functional mitral valve regurgitation and restored hemodynamic stability, enabling successful weaning from cardiopulmonary bypass.
Case Report (n=1)
No
The Alfieri edge-to-edge stitch technique can be a rapid and effective alternative for treating severe functional mitral regurgitation that develops temporarily after aortic valve replacement, enabling successful weaning from cardiopulmonary bypass.
May provide bailout for refractory post-AVR functional MR; leaves open need for prospective validation before wider use.
The outcome in functional mitral regurgitation after aortic valve replacement is unclear. A frail 82-year-old woman with severe aortic valve regurgitation and mild to moderate functional mitral valve regurgitation (NYHA functional class III) was referred to our clinic. In consideration of her frail condition, aortic valve replacement without mitral surgery was performed. She had hemodynamic instability and difficulty to wean off cardiopulmonary bypass caused by severe functional mitral valve regurgitation with left ventricular dilatation. A central Alfieri edge-to-edge stitch was placed between the anatomical middle of the two leaflets of the mitral valve after reinstitution of cardiopulmonary bypass. This eliminated the mitral regurgitation, which enabled successful separation from cardiopulmonary bypass.
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Morimoto et al. (2018) conducted a case report in Severe functional mitral regurgitation after aortic valve replacement (n=1). Central Alfieri edge-to-edge stitch was evaluated on Mitral regurgitation severity and weaning from cardiopulmonary bypass. Placement of a central Alfieri edge-to-edge stitch eliminated severe functional mitral valve regurgitation and restored hemodynamic stability, enabling successful weaning from cardiopulmonary bypass.
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