Severe mitral regurgitation requiring ECMO therapy treated by interventional valve reconstruction using the MitraClip

Catheter Cardiovasc Interv. 2015 Jan 1;85(1):170-5. doi: 10.1002/ccd.25332. Epub 2014 Jan 10.

Abstract

Surgical repair is considered the gold standard in severe mitral valve regurgitation. Multi-organ failure because of acute mitral insufficiency, however, can be challenging to manage as it aggravates to an inoperable state. We report the case of a 59 year old woman who presented with pulmonary oedema because of high grade mitral regurgitation. A recompensation prior to surgery using medical therapy failed and the patient developed a progressive multi-organ failure including pulmonary, circulatory, and renal failure within days. Symptomatically, our patient could be stabilized employing an extracorporeal membrane oxygenation and an intra-aortic balloon pump. A surgical mitral valve repair was ruled out because of the multi-organ failure. We performed an interventional valve reconstruction using the MitraClip device continuing the extracorporeal membrane oxygenation and the intra-aortic balloon counterpulsation therapy during the procedure. After clipping, multi-organ failure regressed and the extracorporeal membrane oxygenation could be explanted at day two after intervention. © 2013 Wiley Periodicals, Inc.

Keywords: MitraClip™ device; case reports; extracorporeal membrane oxygenation; interventional mitral valve repair; mitral valve insufficiency; multiple organ failure.

Publication types

  • Case Reports

MeSH terms

  • Cardiac Catheterization / instrumentation*
  • Echocardiography, Doppler, Color
  • Echocardiography, Three-Dimensional
  • Echocardiography, Transesophageal
  • Equipment Design
  • Extracorporeal Membrane Oxygenation*
  • Female
  • Humans
  • Intra-Aortic Balloon Pumping
  • Middle Aged
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / therapy*
  • Mitral Valve* / diagnostic imaging
  • Mitral Valve* / physiopathology
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / physiopathology
  • Multiple Organ Failure / therapy*
  • Pulmonary Edema / etiology
  • Pulmonary Edema / physiopathology
  • Recovery of Function
  • Severity of Illness Index
  • Treatment Outcome