Dec 24th 2020

Mitral and Tricuspid Valve Transcatheter Edge-to-Edge Repair

83-year-old female presented to another hospital for worsening dyspnea on exertion (from NYHA FC II to IV) and lower extremity edema. Medical history included atrial fibrillation on oral anticoagulation with Warfarin, and heart failure with reduced ejection fraction (LVEF 35-40%). Transthoracic echocardiogram showed moderate to severe secondary mitral regurgitation (MR) and severe tricuspid regurgitation (TR) and therefore she was referred for transcatheter therapy. Transesophageal echocardiogram showed severe MR (MV gradient 1.5 mmHg and no leaflet calcium) and severe TR with most of the TR jet from anterior-septal commissure, coaptation gap <10mm, and no pacer leads. She underwent successful mitral valve repair (2 clips with trivial residual MR and MV gradient 5 mmHg) and tricuspid valve repair (1 clip in the anteroseptal commissure and mild-moderate residual TR). At 30-day follow up she was asymptomatic and had mild lower extremity edema. Transthoracic echocardiogram showed mild residual TR and MR with stable clips.