MitraClip implantation plus left atrial appendage occlusion in a hereditary hemorrhagic telangiectasia patient

• Published in: Future cardiology Vol. 18; no. 11; pp. 849 - 855
• Main Authors: D’Alessandro, Pasquale, Tritto, Rocco, Cillis, Emanuela De, Acquaviva, Tommaso, Giordano, Arturo, Nestola, Palma L, Pepe, Martino, Bortone, Alessandro S
• Format: Journal Article
• Language: English
• Published: Future Medicine Ltd 01-11-2022
• Subjects: atrial fibrillation; hemostasis; hereditary hemorrhagic telangiectasia; interventional; left atrial appendage occlusion; MitraClip; mitral regurgitation
• ISSN: 1479-6678; 1744-8298
• DOI: 10.2217/fca-2022-0043

Hereditary hemorrhagic telangiectasia is regarded as a high hemorrhagic risk condition, and the management of anticoagulation and heart surgery in these patients can be challenging. The authors describe a combined percutaneous treatment of mitral regurgitation and left atrial appendage occlusion in a patient affected by hereditary hemorrhagic telangiectasia and atrial fibrillation, supporting the safety and feasibility of the procedure and the optimal short-term outcome.
Hereditary hemorrhagic telangiectasia is a disease that carries a high risk of bleeding because of the growth of blood vessels with weak walls. The authors describe the case of a patient with hereditary hemorrhagic telangiectasia needing an intervention for mitral valve regurgitation and anticoagulation therapy for atrial fibrillation. To reduce the bleeding risk, two innovative techniques were used: the mitral valve disease was treated with the percutaneous implantation of stitches without open chest surgery and the left atrial appendage was contextually occluded thanks to another mini-invasive procedure to avoid the need for anticoagulation.
The authors describe the combined percutaneous treatment of mitral regurgitation and left atrial appendage occlusion in a patient with hereditary hemorrhagic telangiectasia.