Successful Treatment of Mitral Regurgitation after Transapical Transcatheter Aortic Valve Implantation by Percutaneous Edge-to-edge Mitral Valve Repair (MitraClip®) -The First Combination Therapy Performed in Japan

Atsushi Okada; Hideaki Kanzaki; Makoto Amaki; Yu Kataoka; Koji Miyamoto; Yasuhiro Hamatani; Masashi Fujino; Hiroyuki Takahama; Takuya Hasegawa; Yusuke Shimahara; Yoshiaki Morita; Yasuo Sugano; Kengo Kusano; Yoshihiko Ohnishi; Tomoyuki Fujita; Junjiro Kobayashi; Toshihisa Anzai; Satoshi Yasuda

doi:10.2169/internalmedicine.9663-17

Successful Treatment of Mitral Regurgitation after Transapical Transcatheter Aortic Valve Implantation by Percutaneous Edge-to-edge Mitral Valve Repair (MitraClip^®) -The First Combination Therapy Performed in Japan

Intern Med. 2018 Apr 15;57(8):1105-1109. doi: 10.2169/internalmedicine.9663-17. Epub 2017 Dec 21.

Authors

Atsushi Okada¹, Hideaki Kanzaki¹, Makoto Amaki¹, Yu Kataoka¹, Koji Miyamoto¹, Yasuhiro Hamatani¹, Masashi Fujino¹, Hiroyuki Takahama¹, Takuya Hasegawa¹, Yusuke Shimahara², Yoshiaki Morita³, Yasuo Sugano¹, Kengo Kusano¹, Yoshihiko Ohnishi⁴, Tomoyuki Fujita², Junjiro Kobayashi², Toshihisa Anzai¹, Satoshi Yasuda¹

Affiliations

¹ Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan.
² Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Japan.
³ Department of Radiology, National Cerebral and Cardiovascular Center, Japan.
⁴ Department of Anesthesiology, National Cerebral and Cardiovascular Center, Japan.

Abstract

A 75-year old man with a history of inferior myocardial infarction was admitted with symptoms of progressive heart failure 3 months after undergoing transapical transcatheter aortic valve implantation (TAVI). Echocardiography revealed severe mitral regurgitation (MR) caused by posterior leaflet tethering, without traumatic injury of the mitral valve or chordae. The patient was successfully treated by percutaneous edge-to-edge mitral valve repair (MitraClip^®). This case highlights the role of MitraClip^® in high-risk patients suffering from MR, and suggests that apical contractile loss or adhesion caused by apical puncture and suturing in transapical TAVI may be one of the mechanisms of worsening MR.

Keywords: MitraClip; TAVI; mitral regurgitation; percutaneous edge-to-edge mitral valve repair; tethering; transcatheter aortic valve implantation.

Publication types

Case Reports

MeSH terms

Aged
Cardiac Surgical Procedures / methods*
Echocardiography
Humans
Japan
Male
Mitral Valve / diagnostic imaging
Mitral Valve / surgery*
Mitral Valve Insufficiency / surgery*
Transcatheter Aortic Valve Replacement / methods
Treatment Outcome