经心尖经导管主动脉瓣置换术所致前叶连枷引起的二尖瓣经导管缘对缘修复术

Mitral Transcatheter Edge-to-Edge Repair for Anterior Leaflet Flail Induced by Transapical Transcatheter Aortic Valve Replacement.

作者信息

Betti Matteo, Streukens Sebastian A F, Kats Suzanne, Maesen Bart, Vainer Jindra, Theunissen Ralph A L J, van 't Hof Arnoud W J, Vriesendorp Pieter A

机构信息

Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.

Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands.

出版信息

JACC Case Rep. 2025 Aug 6;30(22):104653. doi: 10.1016/j.jaccas.2025.104653.

DOI:10.1016/j.jaccas.2025.104653

PMID:40780765

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12426552/

Abstract

BACKGROUND

Transapical transcatheter aortic valve replacement (TA-TAVR) is a viable option for inoperable patients who are not eligible for a transfemoral route. Rarely, delayed complications such as primary mitral regurgitation (MR) may emerge owing to procedural factors.

CASE SUMMARY

An 85-year-old patient deemed at high surgical risk underwent TA-TAVR successfully for severe symptomatic aortic stenosis. Two months after the procedure, he returned with progressive dyspnea secondary to severe MR caused by anterior mitral leaflet flail. Mitral transcatheter edge-to-edge repair (M-TEER) was performed with a significant reduction in MR severity and notable symptomatic improvement.

DISCUSSION

This case describes an unusual late-onset complication of TA-TAVR. Early recognition and reintervention were key, as M-TEER offered a safe and effective strategy for treating this atypical complication.

TAKE-HOME MESSAGE: Severe primary MR can be a complication of TA-TAVR that may not be detectable in the immediate postoperative period, and M-TEER can be a valid option for its treatment.

摘要