Hemolytic Anemia After Surgical Mitral Valve Repair Treated With Transcatheter Edge-to-Edge Device

Figures

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  Figure 1. Hemolysis Parameter Evolution Temporal evolution of hemolysis parameters related to surgical and percutaneous mitral valve repair. Hb = hemoglobin; TEER = transcatheter edge-to-edge repair.

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  Figure 2. Mitral Valve Before and After Surgical Repair Transesophageal echocardiographic view of posterior leaflet flail with (A) 2-dimensional and (B) 3imensional images before surgery. (C to E) The same perspectives after surgery repair achieving mild mitral regurgitation (E) at the end of the intervention.

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  Figure 3. Mitral Regurgitation Causing Hemolysis Mitral regurgitation on admission for hemolysis. Note the broken neochords (arrows) prolapsing into the left atrium in the 3-dimensional mitral valve view with and without color (A, B), as well as in the 2-dimensional image (C) and the eccentric jet directed toward the surgical mitral ring.

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  Figure 4. Mitral Valve Gradients Before and During TEER Intervention bpm = beats per minute; grad = gradient; max V = maximum velocity; MV = mitral valve; PHT = pressure half-time; TEER = transcatheter edge-to-edge repair.

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  Figure 5. Transcatheter Mitral Valve Repair The transcatheter edge-to-edge repair procedure, (A) starting with the transcatheter edge-to-edge repair “grasping view” and the capture or residual mitral prolapse, (B) with final mild regurgitation and (C) significant improvement of pulmonary vein hemodynamics (top, an inverted S-wave; bottom, a recovered profile). (D and E) 3-dimensional imaging showing the final result.