MitraClip combined with PTSBME for the treatment of obstructive hypertrophic cardiomyopathy with severe mitral regurgitation: a case report.

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is the hereditary cardiomyopathy with the highest incidence rate. Its main pathological changes are ventricular septal myocardial hypertrophy and myocardial disorder, which are prone to fatal arrhythmia and heart failure. If left ventricular outflow tract (LVOT) obstruction is combined, it is called obstructive hypertrophic cardiomyopathy (oHCM). There is currently no report on the use of MitraClip combined with percutaneous transluminal septal branch microsphere embolization (PTSBME) for treating patients with oHCM complicated with severe mitral regurgitation (MR).

Case presentation: This report describes a 51-year-old male patient who was admitted to the hospital due to "repeated chest tightness and shortness of breath for 2 years, worsening for 6 months". Ultrasound, left ventricular angiography (LVA), and left cardiac catheterization confirmed oHCM with moderate MR. We used MitraClip combined with PTSBME to relieve the patient's LVOT obstruction and MR simultaneously.

Conclusions: Traditionally, both interventricular septal and mitral valve lesions are treated simultaneously through surgical intervention. However, the surgical conditions are relatively strict, and many patients are unable to undergo surgical treatment, resulting in delays in their condition. For such patients, minimally invasive intervention may be used to simultaneously treat interventricular septal and mitral valve lesions, further reducing surgical risks and enhancing surgical efficacy. In this case, MitraClip combined with PTSBME was first performed. After the surgery, the patient's LVOT obstruction and MR were simultaneously relieved, and clinical symptoms improved significantly.