Dataset Information

Killing two birds with one stone-MitraClip for flail P2 and systolic anterior motion of mitral valve: a case report.

ABSTRACT:

Background

The MitraClip system has been used extensively in high-risk patients with severe degenerative mitral regurgitation (MR). Recent reports have demonstrated the feasibility of using the MitraClip device to treat systolic anterior motion (SAM) of the mitral valve in obstructive hypertrophic cardiomyopathy (HOCM).

Case summary

We report the case of a 76-year-old lady who had both symptomatic severe degenerative MR and HOCM that were refractory to medical therapy. Both pathologies were treated successfully using the MitraClip system.

Discussion

In patients who are deemed to be at high risk for open surgery, our case demonstrated the feasibility of a percutaneous avenue, the MitraClip system, to treat not just degenerative MR, but also SAM from HOCM in a single procedure.

SUBMITTER: Wong N

PROVIDER: S-EPMC6426007 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Killing two birds with one stone-MitraClip for flail P2 and systolic anterior motion of mitral valve: a case report.

Wong Ningyan N Hamid Nadira N Tang Hak Chiaw HC Yeo Khung Keong KK

European heart journal. Case reports 20181211 4

<h4>Background</h4>The MitraClip system has been used extensively in high-risk patients with severe degenerative mitral regurgitation (MR). Recent reports have demonstrated the feasibility of using the MitraClip device to treat systolic anterior motion (SAM) of the mitral valve in obstructive hypertrophic cardiomyopathy (HOCM).<h4>Case summary</h4>We report the case of a 76-year-old lady who had both symptomatic severe degenerative MR and HOCM that were refractory to medical therapy. Both pathol ...[more]

PMID: 31020221

Similar Datasets

Project description:Background and objectiveThe prevalence of hypertrophic cardiomyopathy (HCM) is estimated to be 1 in 200 to 500 individuals, with systolic anterior motion (SAM) of the mitral valve (MV) and left ventricular outflow tract (LVOT) obstruction present in 60% to 70%. In this narrative review, we aim to elucidate the pathophysiology of SAM-septal contact and LVOT obstruction in HCM by presenting a detailed review on the anatomy of the MV apparatus in HCM, examining the various existing theories pertaining to the SAM phenomenon as supported by cardiac imaging, and providing a critical assessment of management strategies for SAM in HCM.MethodsA literature review was performed using PubMed, EMBASE, Ovid, and the Cochrane Library, of all scientific articles published through December 2021. A focus was placed on descriptive studies, reports correlating echocardiographic findings with pathologic diagnosis, and outcomes studies.Key content and findingsThe pathophysiology of SAM involves the complex interplay between HCM morphology, MV apparatus anatomic abnormalities, and labile hemodynamic derangements. Echocardiography and cardiac magnetic resonance (CMR) vector flow mapping have identified drag forces, as opposed to the "Venturi effect", as the main hydraulic forces responsible for SAM. The degree of mitral regurgitation with SAM is variable, and its severity is correlated with degree of LVOT obstruction and outcomes. First line therapy for the amelioration of SAM and LVOT obstruction is medical therapy with beta-blockers, non-dihydropyridine calcium-channel blockers, and disopyramide, in conjunction with lifestyle modifications. In refractory cases septal reduction therapy is performed, which may be combined with a 'resect-plicate-release' procedure, anterior mitral leaflet extension, surgical edge-to-edge MV repair, anterior mitral leaflet retention plasty, or secondary chordal cutting.ConclusionsRecent scientific advances in the field of HCM have allowed for a maturation of our understanding of the SAM phenomenon. Cardiac imaging plays a critical role in its diagnosis, treatment, and surveillance, and in our ability to apply the appropriate therapeutic regimens. The increasing prevalence of HCM places an emphasis on continued basic and clinical research to further improve outcomes for this challenging population.

Dataset Information

Killing two birds with one stone-MitraClip for flail P2 and systolic anterior motion of mitral valve: a case report.

Background

Case summary

Discussion

Publications

Killing two birds with one stone-MitraClip for flail P2 and systolic anterior motion of mitral valve: a case report.

Similar Datasets

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