A case report of percutaneous MitraClip implantation in an adult with a double-outlet right ventricle

Author:

Kumar Preetham1ORCID,Gordon Brent M2,Kheiwa Ahmed2,Abudayyeh Islam34

Affiliation:

1. Division of Cardiology, Department of Medicine, University of California, Riverside , 900 University Ave, Riverside, CA 92521 , USA

2. Division of Pediatric Cardiology, Department of Pediatrics, Loma Linda University Children’s Hospital , Loma Linda, CA , USA

3. Division of Cardiology, Department of Medicine, Loma Linda University Medical Center , Loma Linda, CA , USA

4. Section of Cardiology, Department of Medicine, Veterans Administration Loma Linda Healthcare System , Loma Linda, CA , USA

Abstract

Abstract Background Atrioventricular valve regurgitation (AVVR) is present in up to 75% of Fontan patients, and it is associated with an increased risk of Fontan circulation failure, morbidity, and mortality. Traditional treatment options include surgical repair vs. surgical replacement. We present, to the best of our knowledge, one of the first cases of successful trans-catheter repair of severe common AVVR using the MitraClip device. Case summary A 20-year-old male with a history of double-outlet right ventricle (DORV) with unbalanced common atrioventricular canal to the right ventricle, severely hypoplastic left ventricle, and total anomalous pulmonary venous return status post-Fontan procedure presented with progressively worsening dyspnoea on exertion. Transoesophageal echocardiogram demonstrated severe common AVVR. After discussion of the case during the adult congenital heart disease multidisciplinary conference, patient underwent successful placement of two MitraClip devices, reducing the regurgitation from torrential to moderate. Discussion MitraClip therapy can be used to alleviate symptoms in patients deemed as high risk for surgery. However, careful attention must be paid to haemodynamics before and after clip placement, which may predict short-term clinical outcomes.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

Reference6 articles.

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