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Open Access 26-03-2025 | Cardiomyopathy | Case Report

MitraClip combined with PTSBME for the treatment of obstructive hypertrophic cardiomyopathy with severe mitral regurgitation: a case report

Authors: Xuewen Wang, Ziwei Liang, Mingxin Liu, Shihao Huang, Gang Pan

Published in: Journal of Cardiothoracic Surgery | Issue 1/2025

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Abstract

Background

Hypertrophic cardiomyopathy (HCM) is the hereditary cardiomyopathy with the highest incidence rate. Its main pathological changes are ventricular septal myocardial hypertrophy and myocardial disorder, which are prone to fatal arrhythmia and heart failure. If left ventricular outflow tract (LVOT) obstruction is combined, it is called obstructive hypertrophic cardiomyopathy (oHCM). There is currently no report on the use of MitraClip combined with percutaneous transluminal septal branch microsphere embolization (PTSBME) for treating patients with oHCM complicated with severe mitral regurgitation (MR).

Case presentation

This report describes a 51-year-old male patient who was admitted to the hospital due to “repeated chest tightness and shortness of breath for 2 years, worsening for 6 months”. Ultrasound, left ventricular angiography (LVA), and left cardiac catheterization confirmed oHCM with moderate MR. We used MitraClip combined with PTSBME to relieve the patient's LVOT obstruction and MR simultaneously.

Conclusions

Traditionally, both interventricular septal and mitral valve lesions are treated simultaneously through surgical intervention. However, the surgical conditions are relatively strict, and many patients are unable to undergo surgical treatment, resulting in delays in their condition. For such patients, minimally invasive intervention may be used to simultaneously treat interventricular septal and mitral valve lesions, further reducing surgical risks and enhancing surgical efficacy. In this case, MitraClip combined with PTSBME was first performed. After the surgery, the patient's LVOT obstruction and MR were simultaneously relieved, and clinical symptoms improved significantly.
Literature
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go back to reference Lapenna E, Nisi T, Carino D, Del Forno B, Ruggeri S, Schiavi D, Meneghin R, Macrì Demartino R, Castiglioni A, Maisano F, Alfieri O, De Bonis M. Surgical treatment of hypertrophic obstructive cardiomyopathy in relatively elderly patients: short- and long-term outcomes. Eur J Cardiothorac Surg. 2022. https://doi.org/10.1093/ejcts/ezac229.CrossRefPubMed Lapenna E, Nisi T, Carino D, Del Forno B, Ruggeri S, Schiavi D, Meneghin R, Macrì Demartino R, Castiglioni A, Maisano F, Alfieri O, De Bonis M. Surgical treatment of hypertrophic obstructive cardiomyopathy in relatively elderly patients: short- and long-term outcomes. Eur J Cardiothorac Surg. 2022. https://​doi.​org/​10.​1093/​ejcts/​ezac229.CrossRefPubMed
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go back to reference Afanasyev A, Bogachev-Prokophiev A, Lenko E, Sharifulin R, Ovcharov M, Kozmin D, Karaskov A. Myectomy with mitral valve repair versus replacement in adult patients with hypertrophic obstructive cardiomyopathy: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2019;28(3):465–72. https://doi.org/10.1093/icvts/ivy269.CrossRefPubMed Afanasyev A, Bogachev-Prokophiev A, Lenko E, Sharifulin R, Ovcharov M, Kozmin D, Karaskov A. Myectomy with mitral valve repair versus replacement in adult patients with hypertrophic obstructive cardiomyopathy: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2019;28(3):465–72. https://​doi.​org/​10.​1093/​icvts/​ivy269.CrossRefPubMed
Metadata
Title
MitraClip combined with PTSBME for the treatment of obstructive hypertrophic cardiomyopathy with severe mitral regurgitation: a case report
Authors
Xuewen Wang
Ziwei Liang
Mingxin Liu
Shihao Huang
Gang Pan
Publication date
26-03-2025

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