Informação da revista
Vol. 42. Núm. 6.
Páginas 579-580 (junho 2023)
Partilhar
Partilhar
Baixar PDF
Mais opções do artigo
Vol. 42. Núm. 6.
Páginas 579-580 (junho 2023)
Image in Cardiology
Acesso de texto completo
Percutaneous mitral valve repair in a multioperated congenital heart disease patient. The importance of alternative echocardiographic views
Reparação percutânea da válvula mitral num doente com cardiopatia congénita multioperada. Importância de incidências ecocardiográficas alternativas
Visitas
1178
Daniel Tébar
Autor para correspondência
daniel.tebar.m@gmail.com

Corresponding author.
, Alfonso Jurado-Román, Lucía Fernández-Gassó, Guillermo Galeote, Santiago Jiménez-Valero, Raúl Moreno, Esteban López de Sá
Cardiology Department, La Paz University Hospital, Madrid, Spain
Este item recebeu
Informação do artigo
Texto Completo
Baixar PDF
Estatísticas
Figuras (1)
Texto Completo

A 50-year-old patient with a history of complex congenital heart disease with multiple reoperations including mechanical aortic valve replacement and bioprosthetic pulmonary valve replacement complicated by endocarditis, underwent percutaneous mitral valve (MV) repair (MVR) due to severe symptomatic mitral regurgitation (MR) caused by anterior leaflet prolapse in a dysplastic valve (Figure 1, panels A and B).

Figure 1
(0.41MB).

The main difficulty of the procedure was to find adequate echocardiographic views to perform the transeptal puncture and valve grasping, since the usual ones were not feasible given the complexity of the patient's heart disease. The use of three-dimensional tools in real-time enabled an adequate orientation to guide the transseptal puncture and evaluate the distance from the foramen ovale to the valve plane (Figure 1, panels C and D). The catheter guide and mitral grasping were performed from transgastric views (Figure 1, panels E and F), which enabled the successful implantation of an NTr MitraClip system (Abbott Laboratories, AbbottPark, IL, USA) with functional and echocardiographic improvement of the MR, leading to a reduction to grade 2 MVR (Figure 1, panels G and H).

Percutaneous MVR with Mitraclip™ is an alternative to high-risk traditional MV surgery even in patients with congenital MV disease. Mitraclip™ implantation in patients with complex congenital heart disease is unusual and the technique is not clearly standardized. Echocardiographic guidance of transcatheter MVR is especially complex because these patients have undergone multiple cardiac surgeries, have an abnormal cardiac position, anatomical variants and intracardiac devices, leading to a suboptimal echocardiographic window in many cases. This case shows the benefits of alternative echocardiographic views that could be helpful and should be considered in this scenario.

Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2023. Sociedade Portuguesa de Cardiologia
Baixar PDF
Idiomas
Revista Portuguesa de Cardiologia
Opções de artigo
Ferramentas
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.