Transcatheter edge-to-edge repair with MitraClip may be a viable alternative to surgery for acute severe mitral regurgitation due to post-MI papillary muscle rupture in selected high-risk patients.
Supports percutaneous mitral repair feasibility in high-risk post-MI papillary muscle rupture; leaves open need for prospective outcome data.
A 75-year-old man was admitted to the emergency department for a late-presenting myocardial infarction. The coronary angiography revealed a thrombotic occlusion of the circumflex artery. He presented a rapid hemodynamic and respiratory deterioration as a result of a severe mitral regurgitation with a flail anterior leaflet due to a partial tear of the medial papillary muscle (PM). Given the patient's comorbidities, a percutaneous mitral valve repair with two-dimensional (2D)/3D transesophageal echocardiography was performed, deploying two MitraClips. MitraClip implantation may be considered in an acute setting of PM tear as an alternative for surgical treatment in selected patients.
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