Browsing by Subject "Mitral valve regurgitation"

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    Long-Term Efficacy of Mitral Valve Transcatheter Edge-to-Edge Repair (M-TEER) for Exercise-Induced Mitral Regurgitation in a Cardiac Resynchronization Therapy (CRT) Non-responder: A Three-Year Follow-Up
    (Springer Nature, 2024-10-18) Yagasaki, Hiroto; Suzuki, Takeki; Watanabe, Keitaro; Oshima, Yoshitake; Noda, Toshiyuki; Medicine, School of Medicine
    Mitral valve transcatheter edge-to-edge repair (M-TEER), a minimally invasive procedure that uses a clip to join the mitral valve leaflets, has emerged as an established treatment for severe mitral regurgitation (MR) in drug-refractory heart failure (HF). This case report presents an 80-year-old cardiac resynchronization therapy (CRT) non-responder with a complex cardiac history who underwent successful M-TEER. Despite optimal therapy, including CRT, she experienced recurrent HF symptoms. While resting echocardiography showed mild MR, exercise stress echocardiography (ESE) revealed severe MR. The M-TEER procedure resulted in trivial residual MR and significant symptom improvement. The patient's New York Heart Association (NYHA) functional class improved from III to I, with sustained benefits for three years post procedure. This case highlights the importance of comprehensive MR assessment, including ESE, in complex scenarios. It also underscores the potential long-term benefits of M-TEER in carefully selected CRT non-responders, even with borderline right ventricular function, when supported by thorough multidisciplinary evaluation.
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    Transcatheter Mitral Valve Repair Improves Conduction and Function in a CRT Candidate
    (Elsevier, 2025) Yagasaki, Hiroto; Suzuki, Takeki; Watanabe, Keitaro; Yoshizane, Takashi; Watanabe, Ryota; Warita, Shunichiro; Iwama, Makoto; Noda, Toshiyuki; Medicine, School of Medicine
    Dilated cardiomyopathy (DCM) with severe mitral regurgitation (MR) and left bundle branch block (LBBB) typically indicates cardiac resynchronization therapy (CRT). However, device-related complications can limit CRT's applicability in some patients. A 77-year-old woman with DCM, severe MR, and LBBB underwent mitral valve transcatheter edge-to-edge repair (M-TEER) because of high risk for CRT-related complications. Post-procedure, she showed marked improvement in symptoms, left ventricular function, and QRS duration. This case highlights M-TEER as a potential initial strategy in selected patients with DCM, severe MR, and LBBB when CRT is high risk. The unexpected reduction in QRS duration following M-TEER warrants further investigation. M-TEER may be considered in DCM patients with severe MR and LBBB for whom CRT poses significant challenges. This approach could lead to both mechanical and electrical reverse remodeling in some cases.