JACC. Case reports · 2026
Transcatheter Edge-to-Edge Repair in a Patient With Severe Degenerative Mitral Regurgitation and Mirror-Image Dextrocardia.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Jiang Zhengming, Yang Wei, Tian Liuyang, Song Guangyuan
Аннотация
BACKGROUND: Managing severe degenerative mitral regurgitation (MR) in patients with mirror-image dextrocardia is challenging given the rare, complex anatomy. Transcatheter edge-to-edge repair (TEER) offers a minimally invasive alternative for patients at high surgical risk.
CASE SUMMARY: A 76-year-old woman with dextrocardia presented with NYHA functional class III heart failure due to severe MR from anterior leaflet flail. Given prohibitive surgical risk, she successfully underwent TEER with 2 MitraClip XTR devices. Adaptations for the mirrored anatomy included a modified transseptal puncture site and reversed catheter maneuvering. Postprocedural MR was reduced to trivial without stenosis, with rapid symptomatic improvement.
DISCUSSION: This case confirms the feasibility of TEER for degenerative MR in dextrocardia.
TAKE-HOME MESSAGE: TEER for degenerative MR in dextrocardia is critically dependent on preprocedural planning and specific intraoperative modifications to accommodate the reversed anatomy, expanding minimally invasive options for high-risk patients with complex cardiac conditions.
CASE SUMMARY: A 76-year-old woman with dextrocardia presented with NYHA functional class III heart failure due to severe MR from anterior leaflet flail. Given prohibitive surgical risk, she successfully underwent TEER with 2 MitraClip XTR devices. Adaptations for the mirrored anatomy included a modified transseptal puncture site and reversed catheter maneuvering. Postprocedural MR was reduced to trivial without stenosis, with rapid symptomatic improvement.
DISCUSSION: This case confirms the feasibility of TEER for degenerative MR in dextrocardia.
TAKE-HOME MESSAGE: TEER for degenerative MR in dextrocardia is critically dependent on preprocedural planning and specific intraoperative modifications to accommodate the reversed anatomy, expanding minimally invasive options for high-risk patients with complex cardiac conditions.