JACC. Case reports · 2025
Combined Single-Access Left Atrial Appendage Occlusion and Transcatheter Edge-to-Edge Repair for Mitral and Tricuspid Regurgitation.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Florescu Andrei Georgian, Neylon Antoinette, Duhamel Suzanne, Djebbar Morad, Akodad Mariama, Garot Philippe
Аннотация
BACKGROUND: Mitral valve regurgitation often coexists with tricuspid valve regurgitation and atrial fibrillation, increasing the risk of recurrent heart failure alongside bleeding from oral anticoagulation therapy.
CASE SUMMARY: An 87-year-old man on oral anticoagulation therapy for atrial fibrillation presented with decompensated heart failure and anemia, requiring multiple blood transfusions. Gastrointestinal evaluation revealed chronic gastritis and diverticulosis without active bleeding. Echocardiography showed moderately reduced left ventricular ejection fraction and severe functional mitral and tricuspid regurgitation. A single-access triple procedure was performed: left atrial appendage occlusion followed by mitral and tricuspid percutaneous transcatheter edge-to-edge repair. The procedure was successful, with sustained improvement at follow-up.
DISCUSSION: This is to our knowledge the first reported single-access triple procedure combining left atrial appendage occlusion with mitral and tricuspid transcatheter edge-to-edge repair.
TAKE-HOME MESSAGE: This case, which relied on meticulous imaging and a structured workflow, demonstrates the feasibility and efficacy of this triple procedure in high-risk patients.
CASE SUMMARY: An 87-year-old man on oral anticoagulation therapy for atrial fibrillation presented with decompensated heart failure and anemia, requiring multiple blood transfusions. Gastrointestinal evaluation revealed chronic gastritis and diverticulosis without active bleeding. Echocardiography showed moderately reduced left ventricular ejection fraction and severe functional mitral and tricuspid regurgitation. A single-access triple procedure was performed: left atrial appendage occlusion followed by mitral and tricuspid percutaneous transcatheter edge-to-edge repair. The procedure was successful, with sustained improvement at follow-up.
DISCUSSION: This is to our knowledge the first reported single-access triple procedure combining left atrial appendage occlusion with mitral and tricuspid transcatheter edge-to-edge repair.
TAKE-HOME MESSAGE: This case, which relied on meticulous imaging and a structured workflow, demonstrates the feasibility and efficacy of this triple procedure in high-risk patients.