Zhao CZ, Yan Y, Cui Y, Zhu N, Ding XY. Sequential multidisciplinary minimally invasive therapeutic strategy for heart failure caused by four diseases: A case report. World J Clin Cases 2022; 10(23): 8255-8261 [PMID: 36159518 DOI: 10.12998/wjcc.v10.i23.8255]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2022; 10(23): 8255-8261 Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8255
Sequential multidisciplinary minimally invasive therapeutic strategy for heart failure caused by four diseases: A case report
Chen-Ze Zhao, Yan Yan, Yong Cui, Ni Zhu, Xue-Yan Ding
Chen-Ze Zhao, Xue-Yan Ding, Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China
Yan Yan, Department of Cardiothoracic Surgery, No. 903 Hospital of Chinese People's Liberation Army, Hangzhou 310043, Zhejiang Province, China
Yong Cui, Department of Cardiothoracic Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China
Ni Zhu, Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Zhao CZ wrote the manuscript; Yan Y and Zhu N revised the manuscript; Cui Y participated in the operation; Ding XY participated in the operation and revised the manuscript; All authors have read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 81800342 and 81800138; and Zhejiang Provincial Natural Science Foundation of China, No. LQ20H020012.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: December 8, 2021 Peer-review started: December 8, 2021 First decision: June 7, 2022 Revised: June 18, 2022 Accepted: July 11, 2022 Article in press: July 11, 2022 Published online: August 16, 2022
Abstract
BACKGROUND
The coexistence with patent ductus arteriosus (PDA), mitral valve prolapse (MVP), atrial fibrillation (AF) and hyperthyroidism is extremely rare and complex. The optimal therapeutic strategy is difficult to develop.
CASE SUMMARY
A 27-year-old female with PDA, MVP, AF and hyperthyroidism presented with severe dyspnea. Given that a one-stage operation for PDA, MVP and AF is high risk, we preferred a sequential multidisciplinary minimally invasive therapeutic strategy. First, PDA transcatheter closure was performed. Hyperthyroidism and heart failure were simultaneously controlled via medical treatment. Video-assisted thoracoscopic mitral valve repair and left atrial appendage occlusion were performed when heart failure was controlled. Under this therapeutic strategy, the patient’s sinus rhythm was restored and maintained. Two years after the treatment, the symptoms of heart failure were relieved, and the enlarged heart was reversed.
CONCLUSION
Sequential multidisciplinary therapeutic strategies, which take advantage of both internal medicine and surgical approaches, might be reasonable for this type of disease.
Core Tip: The coexistence of patent ductus arteriosus (PDA), mitral valve prolapse, atrial fibrillation and hyperthyroidism is extremely rare and complex. We proposed a successful sequential multidisciplinary therapeutic strategy for a 27-year-old female suffering from these four diseases in addition to severe heart failure. PDA transcatheter closure, medical treatment and thoracoscopic mitral valve repair were performed sequentially. Two years after the treatment, the symptoms of heart failure were relieved, sinus rhythm was restored, and the enlarged heart was reversed.
