ISSN 1671-5411 CN 11-5329/R
Rossana Taravella, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Asciutto, Salvatore Novo, Giuseppe Cirrincione. The importance of being “not transplantable”. J Geriatr Cardiol 2016; 13(12): 1002-1004. doi: 10.11909/j.issn.1671-5411.2016.12.010
Citation: Rossana Taravella, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Asciutto, Salvatore Novo, Giuseppe Cirrincione. The importance of being “not transplantable”. J Geriatr Cardiol 2016; 13(12): 1002-1004. doi: 10.11909/j.issn.1671-5411.2016.12.010

The importance of being “not transplantable”

doi: 10.11909/j.issn.1671-5411.2016.12.010
  • Received Date: 2016-11-29
  • Rev Recd Date: 2016-12-02
  • Publish Date: 2016-12-28
  • MitraClip therapy for Mitral Regurgitation(MR) in advanced-endstage heart failure(HF),could open a final bridge to improve symptoms and quality of life in \"not transplantable\" patients. We describe a homeless patient with NYHA class III HF, not elegible to heart transplantation for poor socio-economic status,and severe functional MR,treated with MitraClip. The patient was not suitable for conventional mitral valve repair because of high surgical risk and advanced HF (The STS mortality morbidity score=76%; EUROSCORE II=9,7%). Severe MR was confirmed at TEE preoperative evaluation of patient in which severe LV systolic dysfunction, diastolic dysfunction, severe right ventricle dysfunction, moderate tricuspid regurgitation and post-capillary pulmonary hypertension were detected. After 2 MitraClips implantation, TEE documented effective device position in relation to the main regurgitant jet, a MR grade reduction to 2 , with uneventful recovery. A gradual hemodynamic and general improvement was observed at three-month follow-up echocardiography documenting PAPs reduction and LVEF improvement. Beside, the patient showed HF symptoms reduction in NYHA class I-II. Management of functional MR in end-stage HF is an hard challenge, in addiction to the limited patient group feasibility and long-waiting list of heart transplantation. In the setting of this difficult current real-world experience, percutaneous tecnique was able to improve general conditions, quality of life and survival of our referred patient.
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      沈阳化工大学材料科学与工程学院 沈阳 110142

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