Infective endocarditis after transcatheter edge‐to‐edge repair for severe mitral regurgitation; a case report and a systematic review

Yokoyama, Hiroaki; Ochiai, Tomoki; Saito, Shigeru

doi:10.1002/ccd.30751

Cited by 2 publications

(1 citation statement)

References 38 publications

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“…Second, as with any valve procedure, the risk of developing infective endocarditis (IE) is not negligible. We know that IE following M-TEER (mitral) is a rare occurrence, 5 and that right-sided IE, in general, only accounts for 5–10% of all IE cases, 6 but data and case reports for T-TEER are lacking.…”

Section: Introductionmentioning

confidence: 99%

Two ‘firsts’ in a patient with tricuspid valve infective endocarditis following edge-to-edge repair: a case report

Patrascu,

Binder,

Al Farwan

et al. 2024

European Heart Journal - Case Reports

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Background Tricuspid regurgitation (TR) is associated with increased morbidity and mortality. As many elderly TR patients are deemed inoperable, transcatheter edge-to-edge repair (T-TEER) is arising as a viable treatment option. Though procedural safety aspects seem excellent, long-term risks cannot be ignored, including the feasibility of cardiac pacing by endovascular lead implantation at a later time, as well as T-TEER device-related infective endocarditis (IE), in the context of systemic infection. Case summary We present the case of an 80-year-old man with recurrent admissions for right heart failure due to massive TR, despite successful percutaneous mitral valve repair. The patient was turned down for surgery and eventually underwent T-TEER, with successful TR reduction to mild-to-moderate and improvement in quality of life. Five months later, the patient was admitted for symptomatic bradycardia and the first reported pacemaker implantation after T-TEER with a specific tricuspid valve device was performed. Lead implantation was guided by transoesophageal echocardiography, and did not worsen residual TR. Two years later, the patient presented with device-related tricuspid valve IE, again a “first” following T-TEER. Despite antimicrobial therapy, the vegetation embolized through the atrial septal defect caused by prior mitral-TEER and triggered an ischemic stroke. Furthermore, sepsis led to multiorgan failure and eventually death. Discussion TR is an individual predictor of morbidity and mortality, frequently found in elderly, and should be addressed in symptomatic inoperable patients. With the rise of interventional treatment, new challenges face long-term follow-up and treatment after percutaneous repair. This case report underscores the feasibility of endovascular pacemaker lead implantation after T-TEER, while it points to the risk of device-related tricuspid valve IE.

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Section: Introductionmentioning

confidence: 99%