Surgical revision after percutaneous mitral valve repair by edge-to-edge device in high-risk patients.

摘要: Background Patients scheduled for surgery after unsuccessful MitraClip® intervention present increasingly with multiple comorbidities, and they are often referred to the heart team suggest most appropriate intervention. The publication of successful results initial patient cohorts treated MitraClip device has resulted in recruitment more seriously ill patients, who otherwise would have been denied catheter-based/surgical treatment. There reports on conventional failed mitral valve repair device. However, data such procedures remain scarce mostly focused individual case studies. inevitable increase use MitraClip, however, will raise number patients need post making it imperative surgeons understand challenges outcome related this cohort. We our long-term institutional experience highest risk patients. Methods Eighteen underwent at Institution between January 2015 June 2020. These developed recurrent regurgitation grade than 2° various intervals MitraClip. Mitral was performed where possible gross examination Valve/MitraClip were intra-operatively documented. Implanted devices analyzed histopathologically evaluate healing process rule out inflammation. Regular follow-up performed. Results Mean age 74 (±9 years) implantation tertiary institutions. Sixteen eighteen (16/18) received replacement, whereas remaining two extracorporal membrane oxygenation, respectively. Four died sepsis intractable multi organ failure in-hospital. discharged alive hospital different rehabilitation centers. Follow-up complete all Conclusions Surgery is demanding when require persistent or therapy can be successfully implemented as a option selective cases an interdisciplinary approach despite calculated high perioperative mortality risk. should not outright.