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Percutaneous closure of iatrogenic anterior mitral leaflet perforation: a case report

Hesham Abdo Naeim1, Osama Amoudi1, Abeer Mahmood1

  • 1Madinah Cardiac Center, Adult Cardiology Department, Khaled Bin Waleed Street, PO 6167, Madinah, Saudi Arabia.

European Heart Journal. Case Reports
|September 25, 2020
PubMed
Abstract

Insights

A rare case of severe mitral regurgitation caused by anterior mitral leaflet perforation was successfully treated with a percutaneous closure device, avoiding surgery. This transcatheter approach offers a viable alternative for managing such complex cardiac conditions.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Severe mitral regurgitation (MR) from anterior mitral leaflet (AML) perforation is uncommon, often resulting from iatrogenic causes or infective endocarditis.
  • This case highlights a rare instance of AML perforation following cardiac surgery.

Observation:

  • A 60-year-old male with persistent shortness of breath post-coronary artery bypass graft and mitral valve repair presented with severe MR.
  • Echocardiography confirmed a 6 mm perforation in the AML at the A3 segment.

Findings:

  • Percutaneous closure of the AML perforation was performed using a 6 mm Amplatzer septal occluder device.
  • The transcatheter procedure was successful, with the patient discharged the next day and symptom-free at 6-month follow-up.

Implications:

  • Transcatheter closure of AML perforation is a feasible and effective alternative to surgical intervention.
  • Transesophageal echocardiography (TOE) is critical for accurate diagnosis and procedural guidance in these cases.
Keywords:
Anterior mitral leafletCase reportMitral valvePercutaneousPerforation

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