Key result
Transcatheter edge-to-edge repair successfully reduced acute mitral regurgitation in all 5 patients with postinfarction papillary muscle rupture, but only 1 patient (20%) survived to hospital discharge.
Why the study?
While early case reports suggested TEER with MitraClip might serve as an alternative for prohibitive-surgical-risk patients with acute MR due to post-infarction PMR, data on consecutive patients treated for this condition were lacking.
Does transcatheter edge-to-edge repair (TEER) improve hemodynamics and survival in patients with acute mitral regurgitation due to postinfarction papillary muscle rupture?
Case Report (n=5)
No
Does transcatheter edge-to-edge repair (TEER) improve hemodynamics and survival in patients with acute mitral regurgitation due to postinfarction papillary muscle rupture?
While TEER is technically feasible and improves hemodynamics in acute MR due to postinfarction papillary muscle rupture, survival to discharge remains very low, emphasizing the need for highly selective patient criteria.
May offer alternative for prohibitive-risk post-MI PMR; leaves open need for larger prospective studies.
Background: Early case reports have suggested that transcatheter edge-to-edge repair (TEER) with the MitraClip for the treatment of acute mitral regurgitation (MR) due to post-infarction papillary muscle rupture (PMR) may be an alternative for patients at prohibitive surgical risk. However, data on consecutive patients treated for this condition is lacking. Methods: To define the procedural characteristics, medication use, hemodynamic parameters, and imaging data, we present 5 consecutive patients with acute MR from postinfarction PMR treated with TEER at Scripps Memorial Hospital La Jolla between June 2018 and November 2020. Results: Successful reduction of MR and improved hemodynamics were achieved in all cases. Despite the procedural success, only 1 of the 5 patients survived until hospital discharge. Conclusion: TEER may be an effective treatment for acute MR due to postinfarction PMR to reduce MR and improve hemodynamics. Survival to discharge was infrequent, suggesting that TEER may be appropriate only in selected patients.
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Chang et al. (2022) conducted a case report in Acute mitral regurgitation due to postinfarction papillary muscle rupture (n=5). Transcatheter edge-to-edge repair (TEER) with MitraClip was evaluated on Procedural success (reduction of MR) and survival to hospital discharge. Transcatheter edge-to-edge repair successfully reduced acute mitral regurgitation in all 5 patients with postinfarction papillary muscle rupture, but only 1 patient (20%) survived to hospital discharge.
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