Page 42 - Journal of Structural Heart Disease Volume 3, Issue 6

Case Report
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al-chamber pacemaker placement (Figure 6). This abnormal left ventricular activation sequence causes delayed reduction of both the mitral annular size and regurgitant ori ce size, leading to abnormal lea et coaptation and enhanced MR [7].
Moreover, a hallmark of Ebstein’s anomaly is dys- synchrony of the basal septum at the attachment site of the septal lea et [8]. Although the patient had pre- viously undergone surgical tricuspid valve replace- ment, residual septal dyskinesis may have also further contributed to worsened MR.
This case highlights the hemodynamic e ects of right ventricular pacing in MR and demonstrates the potential utility of the MitraClip system as a feasible
and e ective salvage therapy option in refractory cardiogenic shock. Further experience and research is needed to clarify which patients can be hemody- namically signi cantly a ected by right ventricular pacing.
Con ict of Interest
The authors have no con ict of interest relevant to this publication.
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References
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Journal of Structural Heart Disease, December 2017
Volume 3, Issue 6:192-198
Cite this article as: Nguyen HL, Calfon Press MA, Aboulhosn JA, Lin JP, Ben- harash P, Yang EH. Worsening of Func- tional Mitral Regurgitation from Septal Dyssynchrony Induced by Ventricular Pacing in Ebstein's Anomaly Undergo- ing Percutaneous Mitral Valve Repair. Structural Heart Disease. 2017;3(6):192- 198. DOI: https://doi.org/10.12945/j. jshd.2017.033.17