乌鸦传媒

The mitral valve repair device MitraClip can work as a treatment for severe tricuspid regurgitation, according to a German case study.

A 77-year-old woman presented with tricuspid regurgitation and signs of right heart failure in New York Heart Association functional class III. She also had a history of severe chronic obstructive pulmonary disease and atrial fibrillation. Altogether, these factors placed her at "unacceptably high" risk for a surgical procedure.

After implantation of a MitraClip, however, reported , of Albertinen Heart Center in Hamburg, Germany, and colleagues.

"We report the first transfemoral implantation of the MitraClip in a tricuspid valve with severe functional tricuspid regurgitation that resulted in a significant tricuspid regurgitation reduction," the authors wrote online in the Journal of the American College of Cardiology.

"Very similar to functional mitral regurgitation, tricuspid regurgitation is mainly due to ventricular enlargement, annulus dilation, and loss of leaflet coaptation. Thus, percutaneous mitral valve repair therapy might potentially also be applied for tricuspid regurgitation," they explained.

Schofer's group noted that "theoretically, this procedure can be performed from the internal jugular or femoral vein," adding that they "chose the femoral vein as the access site because it gives more stability to the guide catheter and facilitates steering maneuvers."

They further suggested that, for the MitraClip-induced reduction of tricuspid regurgitation, the right atrium must be large enough to steer the guide catheter; there must be sufficient coaptation to get enough tissue for the clip; the echocardiographic view must be good; and the operator should avoid "deep diving" or using extensive movements with the clip to avoid chordae rupture.

Comment