Cargando…
Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report
BACKGROUND: Due to ongoing left ventricular (LV) remodeling and consecutive geometric displacement of both papillary muscles, end-stage heart failure is frequently associated with relevant functional mitral regurgitation (FMR) Type IIIb. Treatment strategies of FMR and their prognostic impact are st...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319855/ https://www.ncbi.nlm.nih.gov/pubmed/32617510 http://dx.doi.org/10.1093/ehjcr/ytaa087 |
_version_ | 1783551132709158912 |
---|---|
author | Pausch, Jonas Sequeira Gross, Tatiana Reichenspurner, Hermann Girdauskas, Evaldas |
author_facet | Pausch, Jonas Sequeira Gross, Tatiana Reichenspurner, Hermann Girdauskas, Evaldas |
author_sort | Pausch, Jonas |
collection | PubMed |
description | BACKGROUND: Due to ongoing left ventricular (LV) remodeling and consecutive geometric displacement of both papillary muscles, end-stage heart failure is frequently associated with relevant functional mitral regurgitation (FMR) Type IIIb. Treatment strategies of FMR and their prognostic impact are still controversial. CASE SUMMARY: We present a case of an 80-year-old patient who suffered from recurrent symptoms of congestive heart failure due to dilated cardiomyopathy and concomitant severe FMR. To specifically address severe tethering of both mitral leaflets heart team decision was to perform minimally invasive mitral valve repair (MVR) including a subannular LV remodeling procedure, instead of an interventional edge-to-edge repair (MitraClip(®) procedure). In addition to mitral valve ring annuloplasty, standardized relocation of both papillary muscles was performed successfully, leading to a complete resolution of mitral leaflet tethering. There were no procedural complications and the patient was discharged with an excellent functional result without residual mitral regurgitation. Furthermore, after 12 and 24 months, he reported an increase of his functional exercise capacity and a remarkable reverse LV remodeling could be demonstrated. DISCUSSION: Novel subannular repair techniques, especially the relocation of both papillary muscles, specifically address severe leaflet tethering in FMR and have an obvious potential to improve long-term competence of MVR. Therefore, they could be considered as a viable therapeutic option even in elderly patients presenting with end-stage cardiomyopathy and severe leaflet tenting. |
format | Online Article Text |
id | pubmed-7319855 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-73198552020-07-01 Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report Pausch, Jonas Sequeira Gross, Tatiana Reichenspurner, Hermann Girdauskas, Evaldas Eur Heart J Case Rep Case Reports BACKGROUND: Due to ongoing left ventricular (LV) remodeling and consecutive geometric displacement of both papillary muscles, end-stage heart failure is frequently associated with relevant functional mitral regurgitation (FMR) Type IIIb. Treatment strategies of FMR and their prognostic impact are still controversial. CASE SUMMARY: We present a case of an 80-year-old patient who suffered from recurrent symptoms of congestive heart failure due to dilated cardiomyopathy and concomitant severe FMR. To specifically address severe tethering of both mitral leaflets heart team decision was to perform minimally invasive mitral valve repair (MVR) including a subannular LV remodeling procedure, instead of an interventional edge-to-edge repair (MitraClip(®) procedure). In addition to mitral valve ring annuloplasty, standardized relocation of both papillary muscles was performed successfully, leading to a complete resolution of mitral leaflet tethering. There were no procedural complications and the patient was discharged with an excellent functional result without residual mitral regurgitation. Furthermore, after 12 and 24 months, he reported an increase of his functional exercise capacity and a remarkable reverse LV remodeling could be demonstrated. DISCUSSION: Novel subannular repair techniques, especially the relocation of both papillary muscles, specifically address severe leaflet tethering in FMR and have an obvious potential to improve long-term competence of MVR. Therefore, they could be considered as a viable therapeutic option even in elderly patients presenting with end-stage cardiomyopathy and severe leaflet tenting. Oxford University Press 2020-04-27 /pmc/articles/PMC7319855/ /pubmed/32617510 http://dx.doi.org/10.1093/ehjcr/ytaa087 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 Reports Pausch, Jonas Sequeira Gross, Tatiana Reichenspurner, Hermann Girdauskas, Evaldas Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report |
title | Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report |
title_full | Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report |
title_fullStr | Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report |
title_full_unstemmed | Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report |
title_short | Left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report |
title_sort | left ventricular reverse remodeling after successful subannular mitral valve repair in end-stage heart failure: a case report |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319855/ https://www.ncbi.nlm.nih.gov/pubmed/32617510 http://dx.doi.org/10.1093/ehjcr/ytaa087 |
work_keys_str_mv | AT pauschjonas leftventricularreverseremodelingaftersuccessfulsubannularmitralvalverepairinendstageheartfailureacasereport AT sequeiragrosstatiana leftventricularreverseremodelingaftersuccessfulsubannularmitralvalverepairinendstageheartfailureacasereport AT reichenspurnerhermann leftventricularreverseremodelingaftersuccessfulsubannularmitralvalverepairinendstageheartfailureacasereport AT girdauskasevaldas leftventricularreverseremodelingaftersuccessfulsubannularmitralvalverepairinendstageheartfailureacasereport |