Cardiac Resynchronization Therapy After Percutaneous Valve Repair in Functional Mitral Regurgitation Management

Yıl 2018, Cilt: 21 Sayı: 1, 75 - 76, 01.04.2018

Tolga Çimen , Tolga Han Efe Hamza Sunman Lale Dinç Asarcıklı Ekrem Yeter

Öz

We
present a case of a 72-year-old female with symptomatic heart failure and
ischaemic functional mitral regurgitation (FMR), who underwent a successful
percutaneous trans-coronary venous mitral annuloplasty with the Carillon™
system. The procedure resulted in some clinical improvement but patient was
still very symptomatic. Six months later, the patient underwent cardiac
resynchronisation (CRT) device implantation, resulting in a further improvement
in clinical and echo­cardiographic measures of FMR. This case suggests a
possible synergistic effect between CRT and percutaneous trans-coronary-venous
mitral annuloplasty.

Anahtar Kelimeler

Mitral regurgitation, percutaneous mitral annuloplasty, cardiac resynchronization therapy

Fonksiyonel Mitral Yetersizliği Tedavisinde Perkütan Kapak Tamiri Sonrası Kardiyak Resenkronizasyon Tedavisi

Öz

Bu
olgu sunumunda kalp yetersizliği semptomları ve iskemik fonksiyonel mitral
yetersizliği (FMR) sebebiyle Carillon™ sistemiyle başarılı olarak koroner venöz
mitral annüloplasti yapılan 72 yaşındaki kadın hasta anlatılmaktadır. İşlem
sonrası bir miktar klinik iyileşme olan hastanın semptomları devam etmekteydi.
Altı ay sonra hastaya kardiyak resenkronizasyon tedavisi (CRT) uygulandı ve hastanın
klinik bulgularında ve ekokardiyografik olarak FMR’sinde olumlu ek iyileşme
sağlandı. Bu olgu CRT ile perkütan trans-koroner-venöz mitral annüloplastinin
olası sinerjistik etkisinden söz etmektedir.

Anahtar Kelimeler

Mitral yetersizliği, perkütan mitral annüloplasti, kardiyak senkronizasyon tedavisi

Kaynakça

• 1. Lamas GA, Mitchell GF, Flaker GC, Sidney CS, Bernard JG, Lofty B, et al. Clinical significance of mitral regurgitation after acute myocardial infarction. Circulation 1997;96:827-33.
• 2. Siminiak T, Jerzykowska O, Kalmucki P, Link R, Baszko A. Cardiac resynchronisation therapy after percutaneous trans-coronary-venous mitral annuloplasty. Kardiol Pol 2013;71:1293-4.
• 3. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease. J Thorac Cardiovasc Surg 2014;148:e1-e132.
• 4. Cleland J, Freemantle N, Ghio S, Fruhwald F, Shankar A, Marijanowski M, et al. Predicting the long-term effects of cardiac resynchronization therapy on mortality from baseline variables and the early response a report from the CARE-HF (Cardiac Resynchronization in Heart Failure) Trial. J Am Coll Cardiol 2008;52:438-45.