Key result
TEER reduces biopsy-induced severe mitral regurgitation to mild in cardiac amyloidosis.
Why the study?
Biopsy-induced severe mitral regurgitation secondary to chordal rupture is a rare, critical complication in cardiac amyloidosis, and its optimal management remains uncertain.
Case Report (n=1)
No
Transcatheter edge-to-edge mitral valve repair is a safe and effective life-saving therapy for severe iatrogenic mitral regurgitation in frail patients with advanced cardiac amyloidosis.
M-TEER may be feasible for iatrogenic MR in frail amyloidosis patients; hypothesis-generating and requires prospective validation before wider use.
BACKGROUND: Cardiac amyloidosis is associated with poor prognosis. Biopsy-induced severe mitral regurgitation (MR) secondary to chordal rupture is a rare but critical complication, and its optimal management remains uncertain. CASE SUMMARY: A 78-year-old man with transthyretin cardiac amyloidosis developed acute severe MR after left ventricular myocardial biopsy, which caused rupture of the chordae tendineae. He presented with NYHA functional class IV heart failure. Given his condition, transcatheter edge-to-edge mitral valve repair (M-TEER) was prioritized. A MitraClip was successfully deployed, reducing the severe MR to mild without complications, and his symptoms markedly improved. DISCUSSION: This is to our knowledge the first reported case of biopsy-induced MR in cardiac amyloidosis successfully managed using M-TEER. This case demonstrates the safety and efficacy of M-TEER in frail patients with iatrogenic mechanical complications. TAKE-HOME MESSAGE: M-TEER may be a life-saving therapy for severe iatrogenic MR in patients with advanced cardiac amyloidosis.
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Kanda et al. (2025) conducted a case report in Transthyretin cardiac amyloidosis with acute severe mitral regurgitation (n=1). Transcatheter edge-to-edge mitral valve repair (M-TEER) was evaluated on Reduction of mitral regurgitation severity. Transcatheter edge-to-edge mitral valve repair successfully reduced biopsy-induced acute severe mitral regurgitation to mild and improved NYHA functional class from IV to II in a frail patient with cardiac amyloidosis.
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