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Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series

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...

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Autores principales: Muraca, Iacopo, Pennesi, Matteo, Carrabba, Nazario, Scudiero, Fernando, Migliorini, Angela, Marchionni, Niccolò, Stefàno, Pierluigi, Valenti, Renato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319845/
https://www.ncbi.nlm.nih.gov/pubmed/32617500
http://dx.doi.org/10.1093/ehjcr/ytaa066
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author Muraca, Iacopo
Pennesi, Matteo
Carrabba, Nazario
Scudiero, Fernando
Migliorini, Angela
Marchionni, Niccolò
Stefàno, Pierluigi
Valenti, Renato
author_facet Muraca, Iacopo
Pennesi, Matteo
Carrabba, Nazario
Scudiero, Fernando
Migliorini, Angela
Marchionni, Niccolò
Stefàno, Pierluigi
Valenti, Renato
author_sort Muraca, Iacopo
collection PubMed
description 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’.
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spelling pubmed-73198452020-07-01 Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series Muraca, Iacopo Pennesi, Matteo Carrabba, Nazario Scudiero, Fernando Migliorini, Angela Marchionni, Niccolò Stefàno, Pierluigi Valenti, Renato Eur Heart J Case Rep Case Series 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’. Oxford University Press 2020-04-03 /pmc/articles/PMC7319845/ /pubmed/32617500 http://dx.doi.org/10.1093/ehjcr/ytaa066 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Series
Muraca, Iacopo
Pennesi, Matteo
Carrabba, Nazario
Scudiero, Fernando
Migliorini, Angela
Marchionni, Niccolò
Stefàno, Pierluigi
Valenti, Renato
Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
title Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
title_full Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
title_fullStr Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
title_full_unstemmed Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
title_short Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
title_sort percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319845/
https://www.ncbi.nlm.nih.gov/pubmed/32617500
http://dx.doi.org/10.1093/ehjcr/ytaa066
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