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Case Reports
. 2025 Feb 19;30(4):102705.
doi: 10.1016/j.jaccas.2024.102705. Epub 2024 Nov 27.

Transcatheter Edge-to-Edge Mitral Valve Repair as Bailout Therapy for Life-Threatening "Suicide Left Ventricle"

Marco Mussardo  1 , Alessandro Mandurino-Mirizzi  2 , Antonio Tondo  2 , Alessandro Cafaro  2 , Luca Quarta  2 , Dionigi Fischetti  2 , Massimiliano Garzya  2 , Carlo Picani  2 , Arturo Giordano  3 , Giuseppe Colonna  2
Affiliations
Case Reports

Transcatheter Edge-to-Edge Mitral Valve Repair as Bailout Therapy for Life-Threatening "Suicide Left Ventricle"

Marco Mussardo et al. JACC Case Rep. .

Abstract

We describe the first case of successful management with transcatheter edge-to-edge mitral valve repair of life-threatening left ventricle outflow tract dynamic obstruction due to systolic anterior motion of mitral leaflet and associated with severe mitral regurgitation developing soon after transcatheter aortic valve replacement.

Keywords: acute heart failure; aortic valve; edge-to-edge mitral valve repair; left ventricle outflow tract obstruction; mitral valve.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Giordano has received consultation fees from Abbott Vascular and Biosensors International, outside of the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Transcatheter Atrial Valve Replacement Procedure (A) Computed tomographic evaluation of aortic valve and left ventricular outflow tract area; (B) final result of transcatheter atrial valve replacement; (C) final aortic transprosthetic gradient; (D) residual paravalvular leak.
Figure 2
Figure 2
Echocardiography in Intensive Care Unit (A) Transthoracic apical view showing aortic prosthesis velocity profile; typical dagger-shaped Doppler profile at (B) mid-ventricle and (C) left ventricular outflow tract (LVOT); (D) transesophageal 4-chamber view showing flow acceleration at LVOT and severe mitral regurgitation.
Figure 3
Figure 3
Transesophageal Echocardiography in Mitral Transcatheter Edge-to-Edge Valve Repair Procedure (A) G4 Clip positioning at A2-P2; (B) residual mild mitral regurgitation; (C) persistent left ventricular outflow tract color acceleration.
Figure 4
Figure 4
Echocardiography at Discharge Transthoracic apical view showing (A) mild mitral regurgitation and (B) normal velocity Doppler profile at left ventricular outflow tract.
Figure 5
Figure 5
Echocardiography at Follow-Up Transthoracic apical view showing (A) left ventricular outflow tract, (B) intraventricular and (C) aortic velocity Doppler profile, (D) mild mitral regurgitation, (E) transmitral gradient, and (F) severity assessment of paravalvular leak by pressure half-time.
Figure 6
Figure 6
Right Heart Catheterization (A) Pulmonary arterial pressure; (B) pulmonary arterial wedge pressure.
See this image and copyright information in PMC

References

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