Progressive Mitral Stenosis After MitraClip Implantation in a Patient With Systemic Inflammatory Disease

Ann Thorac Surg. 2016 Aug;102(2):e89-91. doi: 10.1016/j.athoracsur.2015.12.050.

Abstract

We describe a patient at high surgical risk who was successfully treated with a MitraClip (Abbott Vascular, Menlo Park, CA) without transmitral gradient. She received corticosteroid therapy for systemic lupus erythematosus, and progressive mitral stenosis developed late after MitraClip implantation. It gradually increased and reached 23 mm Hg at 28 months after the procedure; during the same period, her dose of prednisone had to be increased owing to lupus flare. Systemic inflammatory disease has the potential to result in mitral valve inflammation and fibrosis, ultimately causing thickening of the tissue bridge and worsening of the mitral valve obstruction. Preprocedural counseling regarding durability may help in this population.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Angioplasty / instrumentation*
  • Angioplasty / methods
  • Echocardiography, Transesophageal / methods*
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Imaging, Three-Dimensional
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / drug therapy
  • Middle Aged
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / surgery*
  • Mitral Valve Stenosis / diagnostic imaging*
  • Mitral Valve Stenosis / etiology
  • Mitral Valve Stenosis / surgery*
  • Prosthesis Failure
  • Risk Assessment
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones