Percutaneous mitral valve annuloplasty for functional mitral regurgitation: acute results of the first patient treated with the Viacor permanent device and future perspectives.
Cardiovasc Revasc Med
; 11(4): 265.e1-8, 2010.
Article
em En
| MEDLINE
| ID: mdl-20934667
ABSTRACT
BACKGROUND:
There is a need to develop less invasive techniques to manage moderate or severe functional mitral regurgitation in patients at high surgical risk.OBJECTIVE:
We report the acute results of the first patient treated with the permanent Viacor percutaneous transvenous mitral annuloplasty (PTMA) device in North America, introduce the PTOLEMY-2 protocol, and briefly discuss the current status of transvenous mitral valve techniques. CASE REPORT After several episodes of pulmonary edema, an 87-year-old woman was referred for hemodynamic evaluation. Angiography revealed normal coronary arteries and severe mitral regurgitation. Baseline echocardiography showed severe (4+) functional mitral regurgitation. The coronary sinus was cannulated with a 9.5-Fr introducer from a left subclavian approach. After distal positioning of a coronary wire, the 7-Fr PTMA Viacor catheter was advanced to the anterior interventricular vein. Two 130 g/cm rods were then inserted resulting in an acute and dramatic reduction in mitral regurgitation as assessed by continuous transoesophageal echocardiography and which was associated with a sudden rise in arterial blood pressure. The next day, transthoracic echocardiogram showed a significant reduction in effective regurgitant orifice area (EROA) from 41 to 10 mm(2). The patient was discharged home the day following the procedure without complication. In accordance with the PTOLEMY-2 protocol, she will undergo 3-D transthoracic echocardiograms, quality of life assessments, and 6-min walk tests at regular intervals for the next 5 years.CONCLUSION:
PTMA is a promising technique for the treatment of severe mitral regurgitation in selected patients. Further ongoing research will determine the predictors of success and long-term safety and performance of this technique.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cateteres de Demora
/
Anuloplastia da Valva Mitral
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Insuficiência da Valva Mitral
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Guideline
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Prognostic_studies
Limite:
Aged80
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Female
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Humans
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article