Immediate Single-Leaflet Device Detachment in a Patient with Marfan Syndrome Treated with Bail-Out Edge-to-Edge Mitral Valve Repair

Abstract

Mitral transcatheter edge-to-edge repair (MTEER) is the first transcatheter technique for mitral valve repair (MVR) in patients with severe mitral regurgitation (MR) who are considered at high risk for surgical intervention. Mitral valve prolapse with subsequent MR is a common manifestation of Marfan syndrome. MTEER has never been reported as a treatment option in such kind of patients. We describe the case of a 30-year-old patient who was known to have Marfan syndrome which was complicated with severe symptomatic MR. The surgical risk was high, and he preferred transcatheter intervention. MTEER was complicated with an immediate single-leaflet detachment of the first deployed MitraClip XTR. Bail-out edge-to-edge MVR with two additional MitraClip XTR was performed successfully to stabilize the detached clip. The patient's symptoms and quality of life improved significantly after 10 months of follow-up.

MitraClip used for severe mitral regurgitation after surgery for type A aortic dissection combined with Marfan syndrome

“…To the best of our knowledge, this is the first reported case successfully treated with MitraClip for chronic severe mitral regurgitation after surgery for type A aortic dissection combined with Marfan syndrome. In addition, previous case reports demonstrated that MitraClip was also effective in individuals with postacute type A aortic dissection surgery and Marfan syndrome 11,12 . This shows that MitraClip could be a viable option for these high‐risk patients.…”

“…In addition, previous case reports demonstrated that MitraClip was also effective in individuals with postacute type A aortic dissection surgery and Marfan syndrome. 11,12 This shows that MitraClip could be a viable option for these high-risk patients.…”

Transcatheter Mitral Valve Repair with Mitraclip®

“…[ 17 ] One patient had a single leaflet detachment that was successfully managed with stabilization using additional clips. [ 18 ] Only one patient required mitral valve surgery. Overall, our study demonstrated early and sustained improvement in the left ventricular hemodynamics and dimensions, and MR grade post TMVr up to 1-year follow-up with low morbidity and mortality.…”