Transcatheter edge-to-edge repair for acute mitral regurgitation caused fatal coronary artery occlusion due to embolization of fragmented native mitral leaflet tissue from repeated grasping.
Case Report (n=1)
This case highlights an unrecognized mechanism of coronary obstruction during TEER due to embolization of fragile native mitral leaflet tissue.
Transcatheter edge-to-edge repair (TEER) is increasingly used as rescue therapy for severe mitral regurgitation (MR) in patients with prohibitive surgical risk. Although procedural success has been reported even in cardiogenic shock, complications related to leaflet fragility in acute structural MR remain poorly recognized. We report a fatal case in which repeated leaflet grasping during TEER caused perforation and fragmentation of a fragile leaflet, resulting in embolization of native mitral leaflet tissue and acute coronary artery occlusion. Autopsy and histopathology confirmed the embolic material to be mitral leaflet tissue. This case highlights an unrecognized mechanism of coronary obstruction during TEER.
Kosaki et al. (Sun,) conducted a case report in Acute mitral regurgitation (n=1). Transcatheter edge-to-edge repair (TEER) was evaluated. Transcatheter edge-to-edge repair for acute mitral regurgitation caused fatal coronary artery occlusion due to embolization of fragmented native mitral leaflet tissue from repeated grasping.