循環器ジャーナル72巻2号

2024年04月発行

特集 心エコー　何をどこまで評価できるか？ Ⅲ. 心エコーを活かして構造的心疾患を診断・治療する

MitraClipのための心エコー

著者： 荒川雅崇¹ 片岡明久²

所属機関： ¹地方独立行政法人総合病院国保旭中央病院循環器内科 ²帝京大学医学部附属病院循環器内科

ページ範囲：P.298 - P.308

POINT
・MitraClipの効果を最大限に発揮し安全に手技を行うために，適応となる症例を理解して事前に戦略を立てることが重要である．
・術中のエコー画像の描出は，手技成功に関わってくるため，必要となる画像の描出や術中のアセスメントを理解しておく必要がある．

参考文献

1）Siegel RJ, Biner S, Rafique AM, et al. The acute hemodynamic effects of MitraClip therapy. J Am Coll Cardiol 2011 ; 57 : 1658-65.

2）von Bardeleben RS, Mahoney P, Morse MA, et al. 1-Year Outcomes With Fourth-Generation Mitral Valve Transcatheter Edge-to-Edge Repair From the EXPAND G4 Study. JACC Cardiovasc Interv. 2023 ; 16 : 2600-10.

3）Piriou N, Al Habash O, Donal E, et al. The MITRA-HR study : design and rationale of a randomised study of MitraClip transcatheter mitral valve repair in patients with severe primary mitral regurgitation eligible for high-risk surgery. EuroIntervention 2019 ; 15 : e329-e335.

4）Izumi C, Eishi K, Ashihara K, et al. JCS/JSCS/JATS/JSVS 2020 Guidelines on the Management of Valvular Heart Disease. Circ J 2020 ; 84 : 2037-119.

5）Stone GW, Lindenfeld J, Abraham WT, et al. Transcatheter Mitral-Valve Repair in Patients with Heart Failure. N Engl J Med 2018 ; 379 : 2307-18.

6）Stone GW, Abraham WT, Lindenfeld J, et al. Five-Year Follow-up after Transcatheter Repair of Secondary Mitral Regurgitation. N Engl J Med 2023 ; 388 : 2037-48.

7）Obadia JF, Messika-Zeitoun D, Leurent G, et al. Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation. N Engl J Med 2018 ; 379 : 2297-306.

8）Grayburn PA, Sannino A, Packer M. Proportionate and Disproportionate Functional Mitral Regurgitation : A New Conceptual Framework That Reconciles the Results of the MITRA-FR and COAPT Trials. JACC Cardiovasc Imaging 2019 ; 12 : 353-62.

9）Packer M, Grayburn PA. Contrasting Effects of Pharmacological, Procedural, and Surgical Interventions on Proportionate and Disproportionate Functional Mitral Regurgitation in Chronic Heart Failure. Circulation 2019 ; 140 : 779-89.

10）Pibarot P, Delgado V, Bax JJ. MITRA-FR vs. COAPT : lessons from two trials with diametrically opposed results. Eur Heart J Cardiovasc Imaging 2019 ; 20 : 620-4.

11）Lancellotti P, Troisfontaines P, Toussaint AC, et al. Prognostic importance of exercise-induced changes in mitral regurgitation in patients with chronic ischemic left ventricular dysfunction. Circulation 2003 ; 108 : 1713-7.

12）Izumo M, Kuwata S, Ishibashi Y, et al. Prognostic impact of transcatheter mitral valve repair in patients with exercise-induced secondary mitral regurgitation. Eur Heart J Cardiovasc Imaging 2021 ; 22 : 530-8.

13）Kagiyama N, Toki M, Yuri T, et al. Physiological and prognostic differences between types of exercise stress echocardiography for functional mitral regurgitation. Open Heart 2021 ; 8 : e001583.

14）Boekstegers P, Hausleiter J, Baldus S, et al. Percutaneous interventional mitral regurgitation treatment using the Mitra-Clip system. Clin Res Cardiol 2014 ; 103 : 85-96.

15）Kataoka A, Watanabe Y, Katayama T, et al. Novel Method to Avoid Image Interference by Vertebral Body During MitraClip Transseptal Puncture. JACC Cardiovasc Interv 2019 ; 12 : 2553-4.

16）Morikawa T, Miyasaka M, Flint N, et al. Right-to-Left Shunt Through Iatrogenic Atrial Septal Defect After MitraClip Procedure. JACC Cardiovasc Interv 2020 ; 13 : 1544-53.

17）Neuss M, Schau T, Isotani A, et al. Elevated Mitral Valve Pressure Gradient After MitraClip Implantation Deteriorates Long-Term Outcome in Patients With Severe Mitral Regurgitation and Severe Heart Failure. JACC Cardiovasc Interv 2017 ; 10 : 931-9.