Key result
Transcatheter edge-to-edge mitral valve repair immediately reduced severe mitral regurgitation to mild in two patients with left ventricular assist devices, though one patient worsened at one month.
Why the study?
Patients with stage D heart failure requiring LVAD support and concomitant severe mitral regurgitation are difficult to manage because anatomic constraints limit device optimization, repeat sternotomy is typically contraindicated, and heart transplantation may not be feasible or timely.
Does transcatheter edge-to-edge mitral valve repair reduce mitral regurgitation severity and improve symptoms in patients with left ventricular assist devices?
Case Report (n=2)
No
Does transcatheter edge-to-edge mitral valve repair reduce mitral regurgitation severity and improve symptoms in patients with left ventricular assist devices?
Transcatheter edge-to-edge mitral valve repair may be a feasible therapeutic option to reduce severe mitral regurgitation and potentially delay the need for heart transplantation in carefully selected patients with LVADs.
TEER may acutely reduce severe MR in LVAD patients; leaves open durability and requires prospective validation.
Patients with symptomatic stage D heart failure who require left ventricular assist device (LVAD) support and suffer concomitant severe mitral regurgitation are often difficult to manage. One reason is due to cardiac anatomic constraints that limit optimization of the mechanical assist device. Typically, these patients are not candidates for repeat sternotomy with surgical mitral valve repair, and heart transplantation may not be feasible or timely. This case describes two patients with LVAD support who received transcatheter edge-to-edge mitral valve repair for severe, symptomatic mitral regurgitation. We believe this procedure may be a therapeutic option in stable patients with severe mitral regurgitation who require mechanical support.
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Raghunathan et al. (2021) conducted a case report in Severe, symptomatic mitral regurgitation in patients with left ventricular assist devices (n=2). Transcatheter edge-to-edge mitral valve repair (TEER) was evaluated. Transcatheter edge-to-edge mitral valve repair immediately reduced severe mitral regurgitation to mild in two patients with left ventricular assist devices, though one patient worsened at one month.
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