M-TEER using MitraClip G4 System for P3 Prolapse

Case and Plan:

80-year-old female with history of hypertension, hyperlipidemia, chronic Afib (on warfarin), hypothyroidism and poor functional status due to severe knee arthritis. Now presents with exercise tolerance less than 1 block and fatigue. TEE shows LVEF 64% with moderate to severe mitral regurgitation due to posterior leaflet prolapse with major jet from A3/P3. Other echo findings are massive TR and biatrial dilatation and moderate pulmonary hypertension. STS risk mortality for MVr is 1.72%, however, heart team found the patient at high risk for surgical MVR because of her severe frailty. Therefore, she is planned to undergo transcatheter mitral valve edge-to-edge repair using MitraClip G4 via right percutaneous femoral venous access.