Mitral valve transcatheter edge-to-edge repair as bridge therapy in a middle-aged patient with Marfan syndrome

A 45-year-old man was hospitalized at our institution due to congestive heart failure. He had a history of Marfan syndrome and four previous cardiovascular surgeries, including aortic valve replacement with a bioprosthetic valve 9 years previously. Transthoracic echocardiography revealed a myxomatous change of the mitral valve and severe mitral regurgitation (MR). After a thorough discussion, including the durability of a bioprosthetic valve, mitral valve transcatheter edge-to-edge repair (M-TEER) was performed as a bridge to the next cardiovascular surgeries. After the procedure, MR was reduced to mild, and his symptoms significantly improved. The patient has been doing well for 2 years after M-TEER.

Learning objective

The development of catheterization therapy for valvular disease has been remarkable. As the indication of transcatheter therapy for valvular heart disease is extending to lower-risk and relatively younger patients, a heart team should thoughtfully discuss lifetime management with each patient, especially relatively young patients.