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MitraClip implantation under sedation
Inês Delgado1, Ana Fonte Boa1, Ana Filipa Carvalho1
1Department of Anaesthesiology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Revista Portuguesa De Cardiologia
|July 31, 2018
Summary
The MitraClip procedure offers a less invasive option for severe mitral regurgitation in high-risk patients. This case study explores its successful application under deep sedation, improving patient quality of life.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Severe mitral regurgitation (MR) poses significant risks for patients unsuitable for traditional surgery.
- The MitraClip system provides a percutaneous, edge-to-edge leaflet repair alternative.
- General anesthesia is standard, but deep sedation is explored for specific patient profiles.
Observation:
- MitraClip implantation guided by 3D transesophageal echocardiography (TEE) and fluoroscopy.
- A case of MitraClip implantation performed under deep sedation using ketamine and propofol infusion is detailed.
- This approach was used in a patient with comorbidities precluding surgical repair.
Findings:
- MitraClip implantation effectively reduces mitral regurgitation, improving quality of life and functional capacity.
- The procedure avoids sternotomy and cardiopulmonary bypass, leading to shorter recovery times.
- Deep sedation with ketamine and propofol is a viable alternative to general anesthesia for MitraClip procedures.
Implications:
- Deep sedation may expand MitraClip candidacy to a broader range of high-risk patients.
- This approach can potentially reduce procedure-related risks and costs.
- Further research into sedation techniques for transcatheter valve interventions is warranted.
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