Case and Plan:
89-year-old frail female with a history of hypertension, hyperlipidemia, NSTEMI, Afib status post AVN ablation with CRT and status post Watchman left atrial appendage occlusion, stroke, bilateral carotid stenosis, scoliosis, paraesophageal hernia status post Nissen fundoplication, presents with worsening short of breath and dizziness. TTE showed severe functional MR. TEE shows LVEF 45% and mixed atrial and ventricular MR from central A2-P2 segments. Other echo findings are moderate TR and mild pulmonary hypertension. STS risk mortality for MV repair is 6.9%. Heart team found the patient at high risk for surgical MV repair because of her advanced age and frailty. Therefore, she is planned to undergo mitral transcatheter edge-to-edge repair (TEER) using MitraClip G4 via right percutaneous femoral venous access.
