Browsing by Subject "Mitral valve transcatheter edge-to-edge repair"

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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 edge-to-edge repair for post-surgical recurrent mitral regurgitation in hereditary spherocytosis: a case report
    (Oxford University Press, 2025-04-29) Yagasaki, Hiroto; Umeda, Yukio; Suzuki, Takeki; Watanabe, Ryota; Noda, Toshiyuki; Medicine, School of Medicine
    Background: Management of mitral regurgitation (MR) in patients with hereditary spherocytosis (HS) poses unique challenges due to increased haemolysis risk. While surgical mitral valve repair is the standard treatment, the optimal strategy for recurrent MR after initial repair remains unclear, particularly regarding the safety and durability of transcatheter interventions in this high-risk population. Case summary: A 57-year-old woman with HS developed severe recurrent MR 4 years after initial surgical repair that intentionally omitted annuloplasty to minimize haemolysis risk. Given the risks of redo surgery and mechanical valve replacement, mitral valve transcatheter edge-to-edge repair (M-TEER) was performed. The procedure achieved successful MR reduction without causing haemolysis. At the 5-year follow-up, the patient maintained improved functional status with stable moderate MR and no evidence of haemolysis, despite her underlying condition. Discussion: This case demonstrates successful long-term outcomes of M-TEER for post-surgical recurrent MR in a patient with HS. The strategic approach-initial ring-less surgical repair followed by M-TEER-suggests a viable treatment pathway for patients with inherited haemolytic disorders, particularly when minimizing prosthetic material exposure is crucial.