Transcatheter Mitral Repair as a Bridge to Cancer Therapy in a Young Patient With Marantic Endocarditis.

BACKGROUND

Nonbacterial thrombotic endocarditis (NBTE) can cause valvular destruction and severe mitral regurgitation (MR). In multimorbid cancer patients, surgery is often not feasible, complicating timely oncologic therapy.

CASE SUMMARY: A 27-year-old woman presented with systemic embolization and was found to have NBTE involving the aortic and mitral valves caused by ROS1-positive lung adenocarcinoma. She underwent mechanical aortic valve replacement and mitral debridement. Progressive MR led to cardiac decompensation. Mitral valve transcatheter edge-to-edge repair (M-TEER) achieved hemodynamic stabilization and enabled surgical tumor resection.

DISCUSSION: This case highlights the role of M-TEER in stabilizing high-risk, non-operable patients with cancer-associated valve disease. While established in older patients with degenerative MR, its use in young oncology patients with NBTE is rarely reported.

TAKE-HOME MESSAGES: NBTE may be the first sign of malignancy and should be considered in patients with embolism and sterile valve lesions. M-TEER can stabilize high-risk patients and enable timely, potentially curative cancer treatment.