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Q4 Medicine

Journal of Cardiology Cases Pub Date : 2025-03-01 DOI:10.1016/j.jccase.2024.12.002

Takuma Iwaya MD , Makoto Amaki MD, PhD , Hideaki Kanzaki MD, PhD, FJCC , Chisato Izumi MD, PhD, FJCC

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引用次数: 0

摘要

一名 45 岁男子因充血性心力衰竭在我院住院治疗。他有马凡氏综合征病史，曾接受过四次心血管手术，包括九年前用生物人工瓣膜置换主动脉瓣。经胸超声心动图显示二尖瓣有肌瘤样改变和严重的二尖瓣反流（MR）。经过充分讨论，包括生物人工瓣膜的耐久性问题，患者接受了二尖瓣经导管边缘到边缘修补术（M-TEER），作为下一步心血管手术的过渡。术后，MR 已降至轻度，症状也明显改善。学习目的瓣膜病导管治疗的发展令人瞩目。由于经导管治疗瓣膜性心脏病的适应症正在向低风险和相对年轻的患者扩展，因此心脏团队应与每位患者，尤其是相对年轻的患者深思熟虑地讨论终生管理问题。

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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Mitral valve transcatheter edge-to-edge repair as bridge therapy in a middle-aged patient with Marfan syndrome

A 45-year-old man was hospitalized at our institution due to congestive heart failure. He had a history of Marfan syndrome and four previous cardiovascular surgeries, including aortic valve replacement with a bioprosthetic valve 9 years previously. Transthoracic echocardiography revealed a myxomatous change of the mitral valve and severe mitral regurgitation (MR). After a thorough discussion, including the durability of a bioprosthetic valve, mitral valve transcatheter edge-to-edge repair (M-TEER) was performed as a bridge to the next cardiovascular surgeries. After the procedure, MR was reduced to mild, and his symptoms significantly improved. The patient has been doing well for 2 years after M-TEER.

Learning objective

The development of catheterization therapy for valvular disease has been remarkable. As the indication of transcatheter therapy for valvular heart disease is extending to lower-risk and relatively younger patients, a heart team should thoughtfully discuss lifetime management with each patient, especially relatively young patients.

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