Key result
M-TEER with a flexible nitinol device resolves severe MR, enabling mechanical circulatory support weaning.
Why the study?
Severe functional mitral regurgitation due to acute myocardial infarction in profound cardiogenic shock is challenging, particularly when it persists despite successful revascularization.
Does transcatheter edge-to-edge mitral repair with a flexible nitinol device improve severe functional mitral regurgitation and facilitate weaning from mechanical circulatory support in a patient with STEMI and cardiogenic shock?
Case Report (n=1)
No
Does transcatheter edge-to-edge mitral repair with a flexible nitinol device improve severe functional mitral regurgitation and facilitate weaning from mechanical circulatory support in a patient with STEMI and cardiogenic shock?
This report demonstrates the feasibility and clinical success of using a transcatheter flexible nitinol device to treat severe functional mitral regurgitation in a patient with profound cardiogenic shock, facilitating vital weaning from temporary mechanical circulatory support.
Supports feasibility of nitinol M-TEER in cardiogenic shock; leaves open need for prospective trials before broader use.
Background Severe functional mitral valve regurgitation due to acute myocardial infarction in the setting of profound cardiogenic shock presents a challenging treatment scenario. Persistent mitral regurgitation despite successful myocardial revascularization requires a careful and effective treatment approach. Case summary A 54-year-old male was admitted to our cardiac arrest center due to severe cardiogenic shock. The patient underwent percutaneous coronary intervention with stenting of the left main coronary artery, left anterior descending and ostial left circumflex artery in the setting of a ST-elevation myocardial infarction. After successful revascularization cardiogenic shock persisted and advanced temporary mechanical circulatory support with extracorporeal membrane oxygenation and a micro-axial flow pump, a was required. Further diagnostic evaluation revealed severe functional mitral regurgitation despite sufficient left-ventricular unloading. We present a case in which temporary mechanical circulatory support stabilized the patient and mitral regurgitation was successfully eliminated using a transcatheter edge-to-edge repair flexible nitinol device. Discussion While mitral valve transcatheter edge-to-edge repair in cardiogenic shock on mechanical circulatory support is rare, it has shown feasibility and positive outcomes in limited reports. This is the first case using a nitinol edge-to-edge repair device in this context. Our report emphasizes the need for further discussion on device selection and comparative studies to optimize treatment in this high-risk group.
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Schwarzkopf et al. (2026) conducted a case report in Severe functional mitral regurgitation and cardiogenic shock post-STEMI (n=1). Transcatheter edge-to-edge mitral repair (M-TEER) with PASCAL device was evaluated on Reduction of mitral regurgitation and weaning from mechanical circulatory support. M-TEER using a flexible nitinol device successfully reduced severe functional mitral regurgitation to trace levels, enabling successful weaning from temporary mechanical circulatory support.
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