Successful Transcatheter Mitral Edge-to-Edge Repair in Patient With Situs Inversus Due to Kartagener Syndrome

We describe a successful mitral valve transcatheter edge-to-edge repair in a patient with primary ciliary dyskinesia and situs inversus (Kartagener syndrome).

Preprocedural imaging was conducted to understand mirror-image anatomy. Transesophageal echocardiography angulation adjustment was needed for dextrocardia, and the MitraClip system was rotated by 180°for maneuverability. Sequential clip placement was performed with real-time three-dimensional guidance.

Altered anatomy complicates standard echocardiographic views. MitraClip orientation and steerability challenges require device rotation. Transesophageal echocardiography visualization may be impaired by acoustic shadowing; preoperative imaging in supine position is recommended. Vascular anomalies associated with Kartagener syndrome may complicate venous access.

Mitral valve transcatheter edge-to-edge repair is feasible in situs inversus with proper imaging and procedural adjustments. Operator-echocardiographer coordination is critical for procedural success.