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Successful transcatheter edge-to-edge repair for tricuspid regurgitation in a patient with a double-inlet left ventricle and discordant connections of the great arteries: a case report. | LitMetric

AI Article Synopsis

  • In patients with adult congenital heart disease (ACHD), severe atrioventricular valve regurgitation increases the risk of poor health outcomes, but transcatheter interventions may offer a safer alternative to high-risk surgeries.
  • A 44-year-old man with multiple congenital heart defects underwent successful transcatheter edge-to-edge repair (TEER) using the MitraClip for severe tricuspid regurgitation, avoiding the complications associated with traditional surgery.
  • This case highlights the importance of a collaborative heart team and thorough imaging assessments in deciding the best treatment strategies for patients with complex ACHD facing high surgical risks.

Article Abstract

Background: In patients with adult congenital heart disease (ACHD), significant atrioventricular valve regurgitation is an important risk factor for poor outcomes, such as heart failure. However, in many cases, transcatheter intervention may reduce the risk profile to avoid a high surgical risk.

Case Summary: A 44-year-old man with complex ACHD in the form of a double-inlet left ventricle, congenitally corrected transposition of the great arteries, pulmonary atresia, atrial septal defect, and patent ductus arteriosus was referred for the treatment of severe tricuspid regurgitation. He received an aortopulmonary shunt and a left-sided modified Blalock-Taussig shunt during childhood. Because of the patient's high surgical risk due to seroma formation around the two shunts and intra-mediastinal collateral vessels, the heart team opted for transcatheter edge-to-edge repair (TEER) using a MitraClip (Abbott Vascular, Santa Clara, CA, USA). Tricuspid TEER was successfully performed using the MitraClip G4 system. The postoperative course was uneventful, with significant improvements in the New York Heart Association functional class.

Discussion: Our case demonstrates that tricuspid TEER can be an alternative option for patients with complex ACHD who are at high risk for conventional surgeries; however, careful assessment with multimodality imaging and a heart team approach, including a cardiologist, ACHD specialist, cardiac surgeon, anthologist, and intensivist, should be considered.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660915PMC
http://dx.doi.org/10.1093/ehjcr/ytae659DOI Listing

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