Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8255
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
Processing time: 235 Days and 18.5 Hours
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.
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.
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.