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Urgent mechanical circulatory support and transcatheter mitral valve repair for refractory hemodynamic compromise
Author(s) -
Rizik David G.,
Burke Robert F.,
Goldstein James A.
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28439
Subject(s) - medicine , cardiogenic shock , hemodynamics , percutaneous , cardiology , mitral regurgitation , mitral valve , circulatory system , shock (circulatory) , mitral valve repair , surgery , myocardial infarction
Patients presenting with hemodynamic instability attributable to left ventricular systolic dysfunction and concomitant severe mitral regurgitation (MR) are increasingly recognized and pose complex management challenges. Surgical therapy is typically precluded owing to prohibitive mortality. The role of percutaneous mechanical circulatory support in such cases is well established; however, such interventions may be neither sufficient to achieve optimal stability nor prove definitive. The advent of novel catheter‐based mitral repair modalities now offers primary decisive therapeutic intervention. Three cases of cardiogenic shock with severe MR illustrate the salutary hemodynamic and clinical responses to percutaneous mechanical support and valve repair by mitral clip.