On Tuesday, October 24, Vishal Patel, M.D. and Lesley Field, PA-C, presented at the prestigious Transcatheter Cardiovascular Therapeutics (TCT) conference in San Francisco.
The conference attracts thousands of attendees from all over the world and features major medical research breakthroughs from leading researchers and clinicians, including our own Providence providers.
Dr. Patel and Lesley’s presentation, titled “Rural Healthcare: Off Label Salvage Transcatheter Edge to Edge Repair for Severe Primary Mitral Regurgitation”, shared how SRMH's cardiac team saved the life of a patient from another county who had been flown to our hospital's intensive care unit (ICU).
The patient presented with severe shortness of breath due to congestive heart failure complicated by cardiogenic shock and kidney failure. An echocardiogram confirmed the patient had primary mitral regurgitation (a condition where one of the heart's valves, called the mitral valve, does not close completely causing blood to leak into the left atrium) with a flail or basically torn posterior mitral leaflet. The mitral leaflets open and close to allow oxygenated blood to move forward from the lungs into the bottom chamber of the heart, but in this case, the valve was torn resulting in severe leaking back towards the lungs.
“It was almost like the patient had no mitral valve, the leakage was so severe,” said Lesley. “The leaky valve caused fluid to build up in the patient’s lungs – almost as if they were drowning,” said Dr. Patel.
These factors put the patient at such extreme risk that they would be unlikely to survive open heart surgery, which is the traditional way that leaky mitral valves are treated. After a multidisciplinary discussion involving the entire heart team, the decision was made to proceed with an off-label salvage mitral TEER (transcatheter edge to edge repair).
“We determined that challenging placement of a MitraClip which is not typically used to repair such a torn flail leaflet, was the best chance for saving his life,” said Lesley. “The procedure required the MitraClip be placed with extreme precision.”
And it was. The patient fully recovered and was discharged to acute rehab before returning home.
“It was an honor to be chosen to present at the TCT conference and show that this can be a successful way to save the life of a critically-ill patient with this condition,” said Lesley. “It's important for providers to share positive outcomes like this that can help save lives. It also helped get the word out about the complex level of care we provide right here in Santa Rosa.”
Please join us in congratulating Dr. Patel and Lesley on their notable work which is advancing medicine in our community and beyond.
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