MITRACLIP implantation in a patient with Duchenne Muscular Dystrophy

Elenco Abstract

CONCETTA PALERMO

MITRACLIP implantation in a patient with Duchenne Muscular Dystrophy

Autori

CONCETTA PALERMO (CENTRO CLINICO NEMO PEDIATRICO-FONDAZIONE POLICLINICO UNIVERSITARIO AGOSTINO GEMELLI IRCCS ROMA – NEUROPSICHIATRIA INFANTILE)
DANIELA LEONE (CENTRO CLINICO NEMO PEDIATRICO-FONDAZIONE POLICLINICO UNIVERSITARIO AGOSTINO GEMELLI IRCCS ROMA – NEUROPSICHIATRIA INFANTILE)
BIANCA BUCHIGNANI (CENTRO CLINICO NEMO PEDIATRICO-FONDAZIONE POLICLINICO UNIVERSITARIO AGOSTINO GEMELLI IRCCS ROMA – NEUROPSICHIATRIA INFANTILE)
PRISCILLA LAMENDOLA (DIPARTIMENTO DI MEDICINA CARDIOVASCOLARE FONDAZIONE POLICLINICO AGOSTINO GEMELLI IRCCS ROMAI – CARDIOLOGIA)
ANTONELLA LOMBARDO (DIPARTIMENTO DI MEDICINA CARDIOVASCOLARE FONDAZIONE POLICLINICO AGOSTINO GEMELLI IRCCS ROMA , UNIVERSITA CATTOLICA DEL SACRO CUORE ROMA – CARDIOLOGIA)
GAETANO LANZA (DIPARTIMENTO DI MEDICINA CARDIOVASCOLARE FONDAZIONE POLICLINICO AGOSTINO GEMELLI IRCCS ROMA , UNIVERSITA CATTOLICA DEL SACRO CUORE ROMA – CARDIOLOGIA)
FRANCESCO BURZOTTA (DIPARTIMENTO DI MEDICINA CARDIOVASCOLARE FONDAZIONE POLICLINICO AGOSTINO GEMELLI IRCCS ROMA , UNIVERSITA CATTOLICA DEL SACRO CUORE ROMA – CARDIOLOGIA)
EUGENIO MERCURI (CENTRO CLINICO NEMO PEDIATRICO-FONDAZIONE POLICLINICO UNIVERSITARIO AGOSTINO GEMELLI IRCCS ROMA, UNIVERSITA’ CATTOLICA DEL SACRO CUORE ROMA – NEUROPSICHIATRIA INFANTILE)
CARLO TRANI (DIPARTIMENTO DI MEDICINA CARDIOVASCOLARE FONDAZIONE POLICLINICO AGOSTINO GEMELLI IRCCS ROMA , UNIVERSITA’ CATTOLICA DEL SACRO CUORE ROMA – CARDIOLOGIA)
MARIKA PANE (CENTRO CLINICO NEMO PEDIATRICO-FONDAZIONE POLICLINICO UNIVERSITARIO AGOSTINO GEMELLI IRCCS ROMA, UNIVERSITA’ CATTOLICA DEL SACRO CUORE ROMA – NEUROPSICHIATRIA INFANTILE)

Presentatore

CONCETTA PALERMO

Modalità

Poster Session

Abstract

“Duchenne Muscular Dystrophy (DMD) is an inherited X-linked recessive neuromuscular disease caused by mutation of the dystrophin gene, leading to early and progressive muscle deterioration and dilated cardiomyopathy. Here we present the case of a 23-year-old DMD patient with dilated cardiomyopathy, severe systolic-diastolic dysfunction, loop recorder and using bilevel noninvasive ventilation device at night.
The cardiac function assessed using echocardiography at the last follow up revealed a left ventricular ejection fraction of 15% (FE Simpson Biplane) overestimated by moderate-to-severe mitral insufficiency of a functional nature.
The patient was on drug therapy with sacubitril/valsartan, ivabradine, metoprolol, dapaglifozin, furosemide, and eplerenone for heart failure.
Within 3 months, the patient presented 3 episodes of acute pulmonary edema, the first of which required oro-tracheal intubation and ICU admission, while the others required hospitalizations and medical therapy with high-dose diuretics. Therefore, the case was reevaluated in a multidisciplinary team and a mitral clip placement surgery was proposed to the subject to reduce the recurrency of pulmonary edema.
Double MITRACLIP implantation surgery was performed via percutaneous right transfemoral vein with guided transesophageal echocardiography in general anesthesia. The procedure was successful with mild residual regurgitation. In the following 5 months the patients presented no more acute episodes of pulmonary edema.
The Mitral Clip may be a viable palliative option in patients DMD with severe heart failure and moderate-to-severe mitral insufficiency.”