Dual transcatheter edge-to-edge repair in a patient with cardiac amyloidosis and severe secondary mitral and tricuspid regurgitation: a case report.

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal: Case Reports Pub Date : 2024-12-12 eCollection Date: 2024-12-01 DOI:10.1093/ehjcr/ytae601

Julia Vogel, Peter Luedike, Amir Abbas Mahabadi, Tienush Rassaf, Lars Michel

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Abstract

Background: Mitral and tricuspid regurgitation in patients with cardiac amyloidosis (CA) pose significant diagnostic and therapeutic challenges due to its non-specific symptoms and limited treatment options. Transcatheter edge-to-edge repair (TEER) is complicated by altered cardiac geometry, advanced restriction, and potential amyloid valve deposits.

Case summary: We present the case of dual TEER in a 79-year-old male with advanced transthyretin cardiac amyloidosis (ATTR-CA) and severe symptomatic mitral and tricuspid regurgitation. In a staged approach, TEER for both the mitral and tricuspid valves was successfully conducted, resulting in improved valvular function and symptom relief. Transvalvular gradients were 5 mmHg for mitral valve and 2 mmHg for tricuspid valve, each with mild residual regurgitation, improved clinical status, and regressive natriuretic peptides.

Discussion: This case underscores the feasibility of dual TEER in CA patients with valvular involvement. Further research is necessary to optimize treatment strategies and address the multifaceted nature of this complex disease.

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双经导管边缘到边缘修复患者的心脏淀粉样变性和严重的继发性二尖瓣和三尖瓣反流：1例报告。

背景：心脏淀粉样变性（CA）患者的二尖瓣和三尖瓣反流由于其非特异性症状和有限的治疗选择，给诊断和治疗带来了重大挑战。经导管边缘到边缘修复（TEER）由于心脏几何形状改变、晚期限制和潜在的淀粉样瓣膜沉积而变得复杂。病例总结：我们提出的病例双TEER在79岁男性晚期甲状腺素型心脏淀粉样变性（atr - ca）和严重症状二尖瓣和三尖瓣反流。在分阶段的方法中，成功地对二尖瓣和三尖瓣进行了TEER，从而改善了瓣膜功能并缓解了症状。经瓣梯度二尖瓣为5 mmHg，三尖瓣为2 mmHg，均有轻度残余返流，临床状态改善，利钠肽退行。讨论：本病例强调了双TEER在累及瓣膜的CA患者中的可行性。有必要进一步研究以优化治疗策略并解决这种复杂疾病的多面性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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