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First described mitral clip in an adult extracardiac Fontan patient: a case report

Christiane L Haeffele1,2, George K Lui1,2, Lynn Peng2

  • 1Department of Medicine, Division of Cardiovascular Medicine, CV Medicine Division 870 Quarry Rd, Palo Alto, CA 94304, USA.

European Heart Journal. Case Reports
|February 3, 2023
PubMed

Insights

Transcatheter edge-to-edge repair (TEER) offers a new treatment for severe atrioventricular valve regurgitation in adult Fontan patients. This minimally invasive approach improved a patient's condition, showing promise for this complex population.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Advanced heart failure patients benefit from transcatheter edge-to-edge repair (TEER), reducing hospitalizations and improving survival.
  • Adults with Fontan circulation frequently develop severe atrioventricular (AV) valve regurgitation.
  • Conventional surgical repair and heart transplantation pose high mortality risks for Fontan patients with heart failure.

Observation:

  • A 51-year-old female with an extracardiac Fontan experienced severe AV valve regurgitation and functional decline.
  • Due to high surgical risk, TEER with the Abbott MitraClip device was chosen.
  • Mitral regurgitation severity reduced from severe to moderate post-procedure.

Findings:

  • Successful TEER in an adult extracardiac Fontan patient with severe AV valve regurgitation.
  • The procedure effectively reduced the degree of mitral regurgitation.

Implications:

  • TEER represents a potential alternative to high-risk conventional surgeries for adult Fontan patients.
  • As Fontan survivors age, transcatheter interventions may become crucial treatment options.
  • This case highlights the expanding role of minimally invasive cardiac procedures in complex congenital heart disease.
Abstract

Keywords:
Adult congenital heart diseaseCase reportFontanHeart failureMitral clipTranscatheter edge-to-edge repair

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