Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
Open Access
- 3 April 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal - Case Reports
- Vol. 4 (3), 1-7
- https://doi.org/10.1093/ehjcr/ytaa066
Abstract
Background Currently, the use of advanced ventricular support systems during percutaneous mitral valve repair (PMVR) procedures is confined to very few selected cases in emergency or bailout situations. No cases are reported of planned use of ventricular support devices in the subgroup of high-risk patients undergoing PMVR. Case summary We report two cases of planned and ‘protected’ procedures of PMVR with Impella CP mechanical circulatory support. No procedure-related complications occurred. At 6-month clinical follow-up evaluation, an improvement of symptoms and functional class (New York Heart Association) was reported. Discussion In the two cases reported, PMVR with Impella CP assistance was feasible, safe and effective in the setting of severe mitral regurgitation associated with dilated and severe left ventricular dysfunction. Extending the concept of ‘complex high-risk and indicated patients/procedures’ (CHIP) from the environment of coronary intervention, a ‘protected’ approach could lead to improve technical feasibility and clinical outcome in structural interventions, as advocated for ‘protected-percutaneous coronary intervention’.Keywords
This publication has 18 references indexed in Scilit:
- Acute Hypotension After MitraClip Implantation due to Acute Left Ventricular FailureSeminars in Cardiothoracic and Vascular Anesthesia, 2018
- Impella percutaneous left ventricular assist device for severe acute ischaemic mitral regurgitation as a bridge to surgeryBMJ Case Reports, 2017
- Percutaneous Mitral Valve Edge-to-Edge Repair Assisted by Hemodynamic Support DevicesCirculation: Heart Failure, 2017
- Afterload Mismatch After MitraClip Implantation: The Potential Impact of Pharmacologic SupportJournal of Cardiothoracic and Vascular Anesthesia, 2017
- The Feasibility of Transcatheter Edge-to-Edge Repair in the Management of Acute Severe Ischemic Mitral RegurgitationКАРДИОЛОГИЯ УЗБЕКИСТАНА, 2017
- Treatment of Higher-Risk Patients With an Indication for RevascularizationCirculation, 2016
- Safety of MitraClip Implant in the Unstable PatientКАРДИОЛОГИЯ УЗБЕКИСТАНА, 2016
- Risk and outcomes of complications during and after MitraClip implantation: Experience in 828 patients from the German TRAnscatheter mitral valve interventions (TRAMI) registryCatheterization and Cardiovascular Interventions, 2015
- Afterload Mismatch After MitraClip Insertion for Functional Mitral RegurgitationThe American Journal of Cardiology, 2014
- Impact of Hemodynamic Support With Impella 2.5 Versus Intra-Aortic Balloon Pump on Prognostically Important Clinical Outcomes in Patients Undergoing High-Risk Percutaneous Coronary Intervention (from the PROTECT II Randomized Trial)The American Journal of Cardiology, 2013