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Updated: May 15, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Indirect mitral annuloplasty using Carillon device after conduction system pacing resynchronization in patient with
Abdelrahman Elhakim1, Mohamed Elhakim2, Osama Bisht3
1Schleswig-Holstein University Hospital-Kiel, Arnold-Heller-Street 3, Kiel, 24105, Germany. ayelhakim1985@yahoo.com.
Background:
The prevalence of secondary mitral regurgitation (SMR) is increasing due to the aging population. SMR management is a complex disease because at least 2 pathologies are involved. SMR and severely reduced EF are independent risk factors for adverse outcomes. We present the case of a 57-year-old man who presented with dyspnea NYHA III. On echocardiography, a combination of SMR and DCM with EF of 20% were diagnosed. Indirect mitral annuloplasty after CRT-CSP was performed based on the patient's clinical profile and high surgical repair risk. The 3-month follow-up was uneventful.
Discussion:
Mitral valve repair techniques in ventricular SMR with severely reduced EF are controversial due to ongoing debates about long-term repair durability in the setting of left ventricular remodeling. Percutaneous strategies are an alternative for high-risk surgical patients and their indication expanded for more complex anatomy and patient´s comorbidity.
Conclusion:
Indirect mitral annuloplasty with the Carillion device in patients with CRT-CSP due to low EF and severe mitral regurgitation is feasible for the treatment of these combined pathologies and allows more physiological pacing and future M-TEER.
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