Key result
MitraClip reduces severe post-TAVI mitral regurgitation to grade 1+ in a transapical recipient.
Why the study?
The mechanisms and treatment options for severe mitral regurgitation after transapical transcatheter aortic valve implantation were not well established.
Case Report (n=1)
No
May support staged MitraClip after transapical TAVI in select cases; leaves open need for prospective data on outcomes and selection.
A 75-year old man with a history of inferior myocardial infarction was admitted with symptoms of progressive heart failure 3 months after undergoing transapical transcatheter aortic valve implantation (TAVI). Echocardiography revealed severe mitral regurgitation (MR) caused by posterior leaflet tethering, without traumatic injury of the mitral valve or chordae. The patient was successfully treated by percutaneous edge-to-edge mitral valve repair (MitraClip®). This case highlights the role of MitraClip® in high-risk patients suffering from MR, and suggests that apical contractile loss or adhesion caused by apical puncture and suturing in transapical TAVI may be one of the mechanisms of worsening MR.
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Okada et al. (2017) conducted a case report in Mitral regurgitation after transapical transcatheter aortic valve implantation (n=1). Percutaneous edge-to-edge mitral valve repair (MitraClip) was evaluated on Reduction in mitral regurgitation grade. Percutaneous edge-to-edge mitral valve repair using MitraClip successfully reduced severe mitral regurgitation to grade 1+ in a patient following transapical transcatheter aortic valve implantation.
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