TEER for Small Mitral Valve Area: Clip Deployment at a Specific Angle.

INTRODUCTION

Transcatheter edge-to-edge repair has been proven to be safe and effective for mitral regurgitation. In patients with a relatively small mitral valve area, transcatheter edge-to-edge repair may risk inducing mitral stenosis.

CASE SUMMARY: A 76-year-old female patient presented with decompensated heart failure and severe mitral regurgitation. Transthoracic echocardiography revealed an effective regurgitant orifice area of 0.39 cm2. Transesophageal echocardiography revealed anterior leaflet prolapse between the A2-P2 region. The procedure was conducted successfully by using DragonFly system, and the clip was released at an angle of approximately 17°. Transesophageal echocardiography showed the mitral valve pressure gradient was 5 mm Hg and mild regurgitation.

DISCUSSION: The DragonFly system can released safety deployment at a specific angle, which can achieve an effective balance between reducing reflux and controlling mitral valve pressure gradient.