Case report: Concomitant MitraClip implantation for severe mitral regurgitation and plug closure of endocarditis induced fistula between aortic root and left atrium after transcatheter aortic valve implantation
Key result
Concomitant MitraClip implantation and Amplatzer Vascular Plug II closure successfully treated severe mitral regurgitation and an aorto-atrial fistula in a patient with prior TAVI and endocarditis.
Why the study?
Aorto-atrial fistula is a rare complication of infective endocarditis following TAVI, presenting challenges for diagnosis and transcatheter management.
Population
One 79-year-old male with severe MR and an aorto-left atrial fistula after prior TAVI
Comparison
Concomitant MitraClip implantation and vascular plug fistula closure
Design
Case report
Authors
Discussion
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Member takes
Implication
Feasibility of combined transcatheter fistula closure and MitraClip shown in complex anatomy; leaves open questions on durability and patient selection.
Study Design
Type
Case Report (n=1)
Structured PICO
P
Population
A 79-year-old male with severe mitral regurgitation and a history of TAVI complicated by infective endocarditis who underwent a concomitant MitraClip and fistula closure procedure.
I
Intervention
Concomitant MitraClip XTR implantation and occlusion of the aorto-left atrial fistula with an Amplatzer Vascular Plug II 12 mm.
O
Outcome
Procedural success (reduction of MR and occlusion of fistula)
This case demonstrates the feasibility of concomitant transcatheter structural interventions for severe MR and an unexpected aorto-atrial fistula, highlighting the importance of comprehensive intra-procedural TOE.
Cite This Study
Ren et al. (2021) conducted a case report in Severe mitral regurgitation and aorto-atrial fistula post-TAVI (n=1). Concomitant MitraClip implantation and Amplatzer Vascular Plug II closure was evaluated on Procedural success and clinical improvement. Concomitant MitraClip implantation and Amplatzer Vascular Plug II closure successfully treated severe mitral regurgitation and an aorto-atrial fistula in a patient with prior TAVI and endocarditis.