Vascular Plug Closure of Delayed Leaflet Perforation Post-TEER in Patient With Multiple Implantable Devices.

Authors

Guanzhong Chen, Zhenyu Xiong, Menghui Liu, Ziwei Zhou, Jiantong Shen, Min Ye, Fengjuan Yao, Xinxue Liao, Xiaodong Zhuang

Published in

JACC. Case reports. Pages 110745. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

Transcatheter edge-to-edge repair (TEER) is the main minimally invasive therapy for severe mitral regurgitation (MR) in patients at high surgical risk. Roughly 10% of patients develop recurrent MR within 1 year postoperatively. Postprocedural mitral anatomical distortion complicates reintervention, rendering recurrent MR management a common clinical challenge.
A 63-year-old man with multivalvular heart disease, chronic heart failure, multiple implantable devices and dialysis-dependent end-stage renal disease presented with symptomatic severe recurrent MR secondary to delayed anterior mitral leaflet perforation after TEER. Under combined fluoroscopic and 3-dimensional transesophageal echocardiographic guidance, our multidisciplinary team performed transcatheter closure of the perforation using a vascular plug. MR was markedly alleviated, heart failure symptoms resolved, and the patient recovered uneventfully before discharge.
TEER-related leaflet perforation caused severe recurrent MR. Percutaneous plug closure successfully downgraded MR to trivial, confirming the feasibility of this approach for mitral leaflet perforation.

PMID:
42886136
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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