Severe Mitral Regurgitation in Mirror-Image Dextrocardia
Year: 2025
Type: article
Study design: Case Report
Abstract: BACKGROUND: Mirror-image dextrocardia with severe mitral regurgitation (MR) is a rare congenital anomaly that significantly increases the complexity of transcatheter mitral valve edge-to-edge repair (TEER). CASE SUMMARY: We report the case of a 72-year-old woman with mirror-image dextrocardia and severe MR who underwent successful TEER using the MitraClip system. Because of the anatomic reversal, several procedural adaptations were required, including modified transesophageal echocardiography views, adjustments to atrial septal puncture technique, and novel strategies for delivering the clip and resolving the "aortic hug." DISCUSSION: This case highlights the unique technical challenges of performing TEER in a patient with mirror-image dextrocardia. Specific procedural modifications were necessary for optimal catheter navigation and leaflet grasping. TAKE-HOME MESSAGE: TEER in patients with mirror-image dextrocardia and severe MR requires specific adaptations. Successful outcomes require operators with substantial TEER experience and excellent 3-dimensional spatial reasoning.
Source: JACC Case Reports
Authors: Jinxia Zhang, Panguo Zhao, Feng Long, Xiaoliang Fu, Ying Zhang, Yangxin Chen, Dingcheng Xiang
Institutions: Sun Yat-sen University, Sun Yat-sen Memorial Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $850
Award: G3684947083
OpenAlex ID: W4413011799