Combined transcatheter treatment of severe mitral regurgitation and secundum atrial septal defect in an inoperable patient: a case report

Abstract Background Chronic mitral regurgitation is one of the most common valvular heart diseases and is associated with poor outcome. Although other structural diseases are regularly seen in such patients, concomitant atrial septal defects remain a rarity in the elderly. Case summary We report a case of an 82-year old woman with progressive right-sided heart failure due to mitral regurgitation and an atrial septal defect of secundum type, despite optimal medical therapy. Combined transcatheter mitral valve repair by utilizing a separate transseptal puncture and atrial septal defect closure was performed resulting in amelioration of symptoms. Discussion Procedural planning for simultaneous transcatheter therapies of coupled structural heart disease entities remains complex. Our case illustrates feasibility of percutaneous edge-to-edge mitral valve repair and consecutive closure of a large secundum atrial septal defect. Different options of accessing the left atrium should be discussed on an individual basis, while additional atrial septal defect closure may be beneficial in terms of right ventricular function and symptoms of right heart failure.

Download Full-text

Mitral regurgitation detected during the intraoperative period after atrial septal defect closure: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-0964-1 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Joo Hyun Jun ◽

Min-Kyung Kang ◽

Joon-Sang Hyeon ◽

Eunha Choi ◽

Youngrok Kim ◽

...

Keyword(s):

Case Report ◽

Mitral Regurgitation ◽

Atrial Septal Defect ◽

Septal Defect ◽

Defect Closure ◽

Atrial Septal Defect Closure ◽

Intraoperative Period

Download Full-text

Percutaneous Mitral Valve Repair Vs. Stand-Alone Medical Therapy in Patients with Functional Mitral Regurgitation and Heart Failure

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2019.06.008 ◽

2020 ◽

Vol 21 (1) ◽

pp. 52-60 ◽

Cited By ~ 4

Author(s):

Tomás Benito-González ◽

Rodrigo Estévez-Loureiro ◽

Pedro A. Villablanca ◽

Patrizio Armeni ◽

Ignacio Iglesias-Gárriz ◽

...

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Mitral Valve Repair ◽

Medical Therapy ◽

Functional Mitral Regurgitation ◽

Valve Repair ◽

Percutaneous Mitral Valve Repair

Download Full-text

Incidence and Causes of 30-day Readmissions after Surgical Versus Percutaneous Secundum Atrial Septal Defect Closure: A United States Nationwide Analysis

Structural Heart ◽

10.1080/24748706.2018.1559963 ◽

2019 ◽

Vol 3 (2) ◽

pp. 113-120

Author(s):

Mohammad K. Mojadidi ◽

Ahmed N. Mahmoud ◽

Dhruv Mahtta ◽

Muhammad O. Zaman ◽

Islam Y. Elgendy ◽

...

Keyword(s):

United States ◽

Atrial Septal Defect ◽

Septal Defect ◽

Defect Closure ◽

Secundum Atrial Septal Defect ◽

Atrial Septal Defect Closure

Download Full-text

The Novel Use of Mitraclip in a Patient with Combined Multiple Myeloma and Heart Failure with Severe Mitral Regurgitation

Austin Cardio & Cardiovascular Case Reports ◽

10.26420/austincardiocardiovasccaserep.2021.1039 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Abu Ghosh Z ◽

◽

Beeri R ◽

Falah B ◽

Pertz A ◽

...

Keyword(s):

Heart Failure ◽

Multiple Myeloma ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Mitral Valve Repair ◽

Severe Mitral Regurgitation ◽

The Novel ◽

Valve Repair ◽

Oncological Treatment ◽

Patients With Heart Failure

Oncology patients with Heart Failure (HF) and severe Mitral Regurgitation (MR) are often considered to have a prohibitive risk for surgical mitral valve repair/replacement. We describe a patient with active multiple myeloma and significant HF and MR who was treated with MitraClip, which improved symptoms and allowed delivery of optimal oncological treatment.

Download Full-text

Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

Scientific Reports ◽

10.1038/s41598-020-74407-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Alberto Polimeni ◽

Michele Albanese ◽

Nadia Salerno ◽

Iolanda Aquila ◽

Jolanda Sabatino ◽

...

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Mitral Valve Repair ◽

Primary Endpoint ◽

Cardiovascular Death ◽

Valve Repair ◽

Percutaneous Mitral Valve Repair ◽

Percutaneous Valve Repair ◽

Percutaneous Valve

Abstract Percutaneous mitral valve repair has been increasingly performed worldwide after approval. We sought to investigate predictors of clinical outcome in patients with mitral regurgitation undergoing percutaneous valve repair. The MITRA-UMG study, a single-centre registry, retrospectively collected consecutive patients with symptomatic moderate-to-severe or severe MR undergoing MitraClip therapy. The primary endpoint was the composite of cardiovascular death or rehospitalization for heart failure. Between March 2012 and July 2018, a total of 150 consecutive patients admitted to our institution were included. Procedural success was obtained in 95.3% of patients. The composite primary endpoint of cardiovascular death or rehospitalization for HF was met in 55 patients (37.9%) with cumulative incidences of 7.6%, 26.2%, at 30 days and 1-year, respectively. In the Cox multivariate model, NYHA functional class and left ventricular end-diastolic volume index (LVEDVi), independently increased the risk of the primary endpoint at long-term follow-up. At Kaplan–Meier analysis, a LVEDVi > 92 ml/m2 was associated with an increased incidence of the primary endpoint. In this study, patients presenting with dilated ventricles (LVEDVi > 92 ml/m2) and advanced heart failure symptoms (NYHA IV) at baseline carried the worst prognosis after percutaneous mitral valve repair.

Download Full-text