Mitral valve pressure gradient after percutaneous mitral valve repair: every beat counts. (23rd November 2017)

• Record Type: Journal Article
• Authors: Lavall, Daniel; Scheller, Bruno; Werner, Christian; Buob, Axel; Mahfoud, Felix
• Is Part Of: ESC heart failure. Volume 5:Number 1(2018)
• Page Start: 193
• Page End: 196
• Publication Date: 2017-11-23
• Subjects: Percutaneous mitral valve repair -- Mitral valve pressure gradient -- Heart rate -- Global longitudinal strain -- Pulmonary pressures; Heart failure -- Periodicals; 616.129005
• DOI: 10.1002/ehf2.12238
• Languages: English
• ISSNs: 2055-5822

Abstract

Abstract: A patient presented with symptoms of decompensated heart failure 2 months after percutaneous mitral valve (MV) repair. Echocardiography demonstrated impaired left ventricular function with elevated MV pressure gradients and pulmonary pressures during rapid atrial fibrillation. Heart rate control was achieved by implantation of a biventricular pacemaker with subsequent His‐bundle ablation because atrial fibrillation was refractory to medical treatment. During biventricular pacing at different rates (50–110 b.p.m.), heart rate correlated positively with both MV mean pressure gradient and global longitudinal strain and negatively with stroke volume. MV pressure gradients directly translated into elevated pulmonary pressures. Thus, rate control and biventricular pacing improved cardiac haemodynamics.