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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
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Severe mitral regurgitation from Libman-Sacks endocarditis treated with MitraClip: a case report

Wong Ningyan1, Ignasius Aditya Jappar1, Ewe See Hooi1

  • 1Department of Cardiology, National Heart Centre, 5 Hospital Drive, Singapore 169609, Singapore.

European Heart Journal. Case Reports
|October 18, 2021
PubMed

Insights

Transcatheter edge-to-edge repair (TEER) offers a viable treatment for severe mitral regurgitation in systemic lupus erythematosus (SLE) patients, avoiding high-risk surgery.

Area of Science:

  • Cardiology
  • Rheumatology
  • Interventional Cardiology

Background:

  • Systemic lupus erythematosus (SLE) can cause valvulopathy, typically treated with surgery.
  • SLE patients often have comorbidities, increasing surgical risks and mortality.
  • Severe mitral regurgitation (MR) in SLE necessitates treatment but poses challenges.

Observation:

  • A 41-year-old woman with SLE and antiphospholipid syndrome presented with severe MR due to Libman-Sacks endocarditis.
  • She had multiple comorbidities, including lupus nephritis and respiratory compromise, making her a high surgical risk.
  • Her heart failure progressed, with worsening symptoms and reduced left ventricular function.

Findings:

  • Transcatheter edge-to-edge repair (TEER) using the MitraClip system was successfully performed.
  • The patient improved to New York Heart Association functional Class II with mild MR at 1-month follow-up.
  • This indicates a positive outcome for a high-risk patient.

Implications:

  • TEER is a potential alternative to surgery for severe MR in SLE patients with suitable anatomy.
  • This minimally invasive approach may reduce morbidity and mortality in this vulnerable population.
  • Further research should explore TEER's long-term efficacy in SLE valvulopathy.
Abstract

Keywords:
Case reportLibman–Sacks endocarditisMitraClipMitral regurgitationSystemic lupus erythematosus

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