Edge-to-edge transcatheter mitral repair for refractory heart failure: Case report and clinical insights

Abstract

Secondary mitral regurgitation (SMR) aggravates prognosis in heart failure with reduced ejection fraction, particularly when guideline-directed medical therapy (GDMT) fails. Transcatheter edge-to-edge repair (TEER) has emerged as a viable option for high-risk surgical candidates. Herein, we report the case of a 77-year-old male with end-stage non-ischemic dilated cardiomyopathy and severe SMR who experienced five decompensations in three months despite optimal GDMT. This case illustrates that in select patients with advanced heart failure and severe SMR, TEER may provide meaningful symptomatic and hemodynamic improvement when surgical or mechanical circulatory support is not feasible. Key determinants of success included precise anatomic selection, preprocedural optimization with levosimendan and natriuresis-guided diuresis, and structured follow-up. TEER, when integrated into a multidisciplinary care pathway, offers more than palliation-it can help stabilize disease and preserve quality of life.

Cite this article as: Çetinarslan Ö, Uçar FM, Yurdakul S. Edge-to-edge transcatheter mitral repair for refractory heart failure: Case report and clinical insights. D J Med Sci 2025;11(2):92-96. doi: 10.5606/fng.btd.2025.180.

Idea/concept, control/ supervision, critical review, materials: Ö.Ç, F.M.U, S.Y.; Design, literature review, writing the article, data collection and/or processing, analysis and/or interpretation, references and fundings: Ö.Ç.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.