Transcatheter edge-to-edge mitral valve repair for severe heart failure in a young woman with polymyositis: A case report

Q4 Medicine Journal of Cardiology Cases Pub Date : 2024-09-01 DOI:10.1016/j.jccase.2024.06.001

Masayoshi Fujii MD, Tetsuari Onishi MD, PhD, Hiroyuki Yamamoto MD, PhD, Nobuyuki Takahashi MD, Tomofumi Takaya MD, PhD, Hiroya Kawai MD, PhD, FJCC

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Abstract

Polymyositis (PM) and dermatomyositis (DM) are chronic inflammatory muscle disorders characterized by muscle weakness and fatigue. They are histopathologically defined by inflammatory cell infiltrates in the skeletal muscle. In a recent meta-analysis, the incidence of cardiovascular complications in patients with PM/DM ranged from 9 to 72 %, with heart failure being the most commonly reported heart disease. In cases of heart failure accompanied by severe mitral regurgitation that is refractory due to guideline-directed medical therapy, the transcatheter edge-to-edge mitral valve repair (TEER) procedure using the MitraClip (Abbott Vascular, Santa Clara, CA, USA) offers an alternative therapeutic approach. We present a pioneering case report describing the successful application of TEER in a young woman with drug-refractory heart failure due to cardiovascular involvement in PM.

Learning objective

•
In polymyositis (PM)/ dermatomyositis (DM), the most commonly reported clinical heart disorder is heart failure, with some cases attributed to mitral regurgitation.
•
Patients suffering from systemic inflammatory diseases such as PM/DM often face high surgical risk, and the MitraClip is an effective treatment modality.

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经导管二尖瓣边缘对边缘修补术治疗患有多发性肌炎的年轻女性的严重心力衰竭：病例报告

多发性肌炎（PM）和皮肌炎（DM）是以肌肉无力和疲劳为特征的慢性肌肉炎症性疾病。它们的组织病理学特征是骨骼肌中的炎性细胞浸润。在最近的一项荟萃分析中，PM/DM 患者心血管并发症的发病率从 9% 到 72% 不等，其中心力衰竭是最常见的心脏病。对于伴有严重二尖瓣反流的心力衰竭病例，如果药物治疗无效，使用 MitraClip（雅培血管公司，美国加利福尼亚州圣克拉拉市）进行的经导管二尖瓣边缘到边缘修补术（TEER）提供了另一种治疗方法。学习目的-在多发性肌炎（PM）/皮肌炎（DM）中，最常见的临床心脏疾病是心力衰竭，其中一些病例归因于二尖瓣反流。

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