Hemodynamic Impact of MitraClip Procedure for Systemic Tricuspid Regurgitation in Congenitally Corrected Transposition of Great Arteries: A Case Report

Patients with congenitally-corrected transposition of the great arteries (ccTGA) commonly develop significant systemic tricuspid valve regurgitation and systemic right ventricular dysfunction in adulthood, both of which presenting a therapeutic dilemma for the care team. Here we describe the case of a 35-year-old male with congenitally-corrected transposition of the great arteries who presented with severe systemic tricuspid valve regurgitation, biventricular systolic failure, and pulmonary hypertension. Due to prohibitive surgical risk, he underwent percutaneous tricuspid valve repair via MitraClip placement. Post-procedure, he demonstrated rapidly improved symptoms and sustained echocardiographic and hemodynamic evaluations. Few reports exist describing the safety and feasibility of the MitraClip procedure on a systemic tricuspid valve, but to our knowledge, this is the first to describe invasive hemodynamic improvements in patients with this degree of cardiopulmonary sequelae from the congenital lesion. There may be optimism for the MitraClip procedure as bridge to list in patients with ccTGA otherwise initially ineligible for surgical valve intervention or transplant. (c) 2020 Elsevier Inc. All rights reserved.

Automated summary

The case study discussed a 35-year-old male patient with congenitally-corrected transposition of the great arteries presenting with severe systemic tricuspid valve regurgitation and biventricular systolic failure. Percutaneous tricuspid valve repair via MitraClip placement was performed with significant improvement in symptoms post-procedure. This study suggests the potential of MitraClip as a bridge to list in patients initially ineligible for surgical intervention.