23rd European Heart Disease and Heart Failure Congress
Centro Cardiologico Monzino, in Milan
Title: Breaking the rules: treating mitral valve pathology in patients with arrhytmogenic right ventricular dysplasia
Biography: Samer Kassem
Introduction: According to current guidelines, in patients with valvular heart disease (VHD), cardiac surgery should be considered before severe ventricular dysfunction develops.
Methods: A 67-years old man was referred to us with moderate mitral regurgitation (MR). He was previously diagnosed at Our Centre for arrhythmogenic RV dysplasia (ARVD), managed with transcatheter ablation (TCA) for paroxistical atrial fibrillation (PAF) and an Implantable Cardioverter Defibrillator (ICD) to prevent further malignant arrhythmias.
Results: The preoperative transthoracic echocardiogram (TTE) showed bad RV and preserved LV function. Although the MV wasn’t on time for surgery, we decided to treat the patient to prevent biventricular dysfunction.
The patient successfully underwent mitral valve replacement (MVR), without any attempt to repair the valve, to reduce the time on cardiopulmonary bypass (CPB) and left atrial appendage (LAA) closure.
The postoperative (PO) course was uneventful and the patient was discharged on the PO day 7th.
Discussion: The indication for MV surgery changes in presence of ARVD or RV failure due to other conditions. In normal population, surgery is performed in case of severe MR, as suggested by current guidelines, while in these patients, when the MR is still moderate, we can’t no longer ‘wait and see’. According to our experience, this can be considered the right time to indicate surgery