Related Experiment Video
Updated: Jun 23, 2026
07:02
Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy
Published on: September 9, 2020
6.3K
Transcatheter Edge-to-Edge Repair for Acute Mitral Regurgitation due to Postinfarction Papillary Muscle Rupture
Chih-Wei Chang1, Steven Romero1, Matthew J Price1
1Division of Cardiology, Scripps Clinic, San Diego, California.
Summary
Transcatheter edge-to-edge repair (TEER) effectively reduced acute mitral regurgitation (MR) and improved hemodynamics in post-infarction papillary muscle rupture (PMR) patients. However, survival to hospital discharge was low, indicating careful patient selection is crucial.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter edge-to-edge repair (TEER) using the MitraClip has been proposed for acute mitral regurgitation (MR) caused by post-infarction papillary muscle rupture (PMR).
- This approach is considered for patients with prohibitive surgical risk.
- Limited data exists on consecutive patients treated for this specific indication.
Purpose of the Study:
- To evaluate the procedural characteristics, medication use, hemodynamic changes, and imaging findings.
- To assess the outcomes of TEER in patients with acute MR secondary to post-infarction PMR.
Main Methods:
- A case series of 5 consecutive patients with acute MR from post-infarction PMR treated with TEER.
- Data collected included procedural details, medication, hemodynamics, and imaging.
- Treatment was performed at Scripps Memorial Hospital La Jolla between June 2018 and November 2020.
Main Results:
- Successful reduction of MR was achieved in all 5 patients.
- Hemodynamic parameters improved following the TEER procedure.
- Despite procedural success, only one patient survived to hospital discharge.
Conclusions:
- TEER can effectively reduce MR and improve hemodynamics in acute post-infarction PMR.
- The low survival rate to discharge suggests TEER may only be suitable for highly selected patients.
- Further research is needed to identify optimal candidates for TEER in this high-risk population.
Related Concept Videos
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
01:28Mitral Regurgitation IV: Nursing Management
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...