经导管二尖瓣缘对缘修复术治疗二尖瓣后叶腱索断裂致急性左心衰竭1例

Transcatheter edge-to-edge repair in acute mitral regurgitation following acute myocardial infarction:a case report

急性心肌梗死引起的乳头肌缺血和腱索断裂可导致急性二尖瓣重度关闭不全,可致患者出现顽固的左心衰竭或心原性休克,死亡率极高,且急诊行外科开胸瓣膜置换或修补手术往往有很高的手术风险,药物治疗效果差。经导管二尖瓣缘对缘修复术已成为一种治疗二尖瓣反流的有效手段。本文介绍1例老年男性患者,因急性心肌梗死导致二尖瓣后叶脱垂引起急性左心衰竭,采用经导管二尖瓣缘对缘修复术对其进行了有效治疗,随访结果良好,为介入治疗技术在该类急性心肌梗死并发症中的应用提供了参考经验。

Acute mitral regurgitation(MR)in the setting of myocardial infarction(MI)may be the result of papillary muscle rupture(PMR).The clinical presentation can be catastrophic,with refractory cardiogenic shock.This condition is associated with high morbidity and mortality.Transcatheter edge-to-edge repair(TEER)has become increasingly common in treating severe mitral regurgitation.This case details a successful TEER is feasible and safe in patients with acute MR following MI.TEER is an emerging treatment option in this clinical scenario that should be taken into consideration.