Structural heart cases
Edge-to-Edge Mitral Valve Repair with MitraClip – July 2018

87 year old male with known history of mitral regurgitation, hypertension, hyperlipidemia, CAD s/p DES PCI to RCA (2010 and 2015), ischemic cardiomyopathy, carotid artery stenosis, and frailty presents with worsening dyspnea on exertion NYHA Class III for 6 months. A transthoracic echocardiogram showed LVEF 30%, moderately dilated LV (LVIDs 4.8 cm, LVIDd 6.3 cm) with severe global hypokinesis, mildly dilated LA, and severe mitral regurgitation. A subsequent transesophageal echocardiogram (TEE) revealed a moderately dilated LV with annular dilation, partial prolapse of the posterior mitral valve leaflet with severe centrally-directed mitral regurgitation involving the A2/P2 segment and no mitral stenosis. The STS mortality risk for surgical MVR is 4.1% and the logistic Euroscore mortality risk is 13.1%. The patient underwent a Heart Team evaluation and was found to be prohibitive risk for surgical MVR due to comorbidities, advanced age and frailty. Patient is now planned for edge-to-edge mitral valve repair with MitraClip via a transfemoral venous access and transseptal puncture.

1:24:59

comments

Leave a Reply

Your email address will not be published. Required fields are marked *


By submitting this form, you are consenting to receive marketing emails from: Mount Sinai Hospital, One Gustave L. Levy Place, Box, New York, NY, 10029, https://ccclivecases.org. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact

suggestion
Suggestions
Bioprosthetic Aortic ViV TAVR after Valve Fracture and Evolut Pro+ Implantation – November 2020
Views 48

  Case and Plan: 60 year-old male presents with worsening exertional dyspnea (NYHA Class III) and multiple admissions for CHF exacerbation in past 3 months. Past medical history is significant for symptomatic severe aortic insufficiency s/p bioprosthetic AVR (2017) with 23mm Magna 3000 valve, ESRD on HD, HTN and HLD. Recent echocardiogram revealed bioprosthetic valve […]


TF-TAVR with No Contrast – September 2020
Views 155

Case and Plan: 61 year-old-male with ETOH abuse, hepatitis and cirrhosis s/p Liver transplant in 6/2019 at MSH with postop course notable for AKI requiring dialysis (last dialysis 7/6/2019), Hypertension, Anemia, Former smoker, CKD stage III.


59:42
Urgent Appropriately Indicated MitraClip Procedure in Patient with Cardiogenic Shock in Covid-19 Era – May 2020
Views 868

 Case and Plan: 74-year-old male former smoker with PMHx of HTN, HLD, and A Fib (on Eliquis) had IW-STEMI on 02/09/20. Cath showed occluded mRCA with dLM bifurcation disease; S/p DES-PPCI to mRCA. Transthoracic echocardiogram at the time of discharge showed an EF of 55% with moderate MR. Pt had staged PCI to dLM […]


TAVR using Transcarotid Access – March 2020
Tags: |
Views 697

Case and Plan: 73-year-old male with hypertension, hyperlipidemia, parathyroidectomy, renal cell carcinoma s/p nephrectomy and right renal transplant in 2001 on chronic steroids and immunosuppressant therapy, paroxysmal atrial fibrillation on AC with warfarin, chronic diastolic heart failure and severe PAD presents with progressive exertional dyspnea NYHA-Class III for the past month after walking up to […]