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Case Reports
. 2025 Aug 27;30(25):104822.
doi: 10.1016/j.jaccas.2025.104822.

Delayed Device Embolization After TEER of the Mitral Valve as a Rare But Dangerous Complication

Angelique Runkel  1 , Hristo Kirov  1 , Tulio Caldonazo  1 , Sebastian Freiburger  1 , Sven Möbius-Winkler  2 , Marcus Franz  3 , Ali Hamadanchi  2 , Torsten Doenst  4
Affiliations
Case Reports

Delayed Device Embolization After TEER of the Mitral Valve as a Rare But Dangerous Complication

Angelique Runkel et al. JACC Case Rep. .

Abstract

Background: Delayed device embolization is a rare but dangerous complication after transcatheter edge-to-edge repair (TEER).

Case summary: A 79-year-old man with acute decompensated severe structural mitral regurgitation underwent TEER with 2 clips after failed medical attempts at recompensation. Six days later, 1 clip embolized into the abdominal aorta, resulting in recurrent, progressive decompensation and severe mitral regurgitation, requiring urgent mitral valve replacement. Despite initial stabilization, the patient died because of septic complications.

Discussion: Although delayed device embolization is rare, it may be underreported in the current literature and can have serious consequences. This underscores the importance of careful heart team evaluation when choosing between interventional vs surgical strategies.

Take-home message: Device embolization after TEER must be discussed as a rare but serious complication, and particular attention should be given to close post-TEER monitoring, especially in patients with complex anatomy.

Keywords: embolization; mitral valve; mitral valve replacement; transcatheter-edge-to-edge-repair.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Caldonazo has been funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Clinician Scientist Program OrganAge (funding number 413668513), Bonn, Germany, the Deutsche Herzstiftung (DHS, German Heart Foundation) (funding number S/03/23), Frankfurt am Main, Germany, and the Interdisciplinary Center of Clinical Research of the Medical Faculty Jena, Germany. The 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
Postinterventional Imaging Intrainterventional fluoroscopy (left) and postinterventional chest radiograph (right) showing both transcatheter edge-to-edge repair devices in the correct position (red arrows).
Figure 2
Figure 2
Radiograph After 9 Days Chest radiograph performed 9 days after transcatheter edge-to-edge repair showing device embolization of one clip into the abdominal aorta (red arrows).
Figure 3
Figure 3
Postoperative Computed Tomography Postoperative computed tomography showing constant position of the embolized transcatheter edge-to-edge repair device in the aorta (red arrow) and the implanted mitral valve prothesis (blue arrow).
See this image and copyright information in PMC

References

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