Percutaneous repair of systemic atrioventricular valve regurgitation with the MitraClip-NT system in congenitally corrected transposition of great arteries


      In a patient with congenitally corrected transposition of the great arteries, dilatation of the atrioventricular valve annulus related to worsening of systemic ventricular function, which worsened systemic atrioventricular valve (SAVV) functional regurgitation. In this article, we report a case of successful transcatheter treatment with MitraClip (Abbott Vascular, Santa Clara, CA, USA) in a 68-year-old female patient with congenitally corrected transposition of the great arteries and severe SAVV failure using imaging modalities. The patient had been hospitalized four times within 8 months, receiving optimal medical therapy for severe SAVV regurgitation and systemic ventricular failure. In this patient, the risk associated with surgery was considered extremely high owing to severe heart failure and liver cirrhosis. We positioned two clips appropriately, side by side, in between the anterior and septal leaflets, guided by computed tomography and three-dimensional echocardiography. The procedure resulted in optimal post-procedural reduction of regurgitation without stenosis, with a good clinical outcome noted at 2-year follow-up.

      Learning objective

      Since surgery for adult congenital heart disease is linked to high risk, we seek less invasive treatment for such patients. In patients with congenital heart disease and severe valve regurgitation, the use of MitraClip (Abbott Vascular, Santa Clara, CA, USA) could be a feasible option for select cases.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Cardiology Cases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Dobson R.
        • Danton M.
        • Nicola W.
        • Hamish W.
        The natural and unnatural history of the systemic right ventricle in adult survivors.
        J Thorac Cardiovasc Surg. 2013; 145: 1493-1501
        • Filippov A.A.
        • Del Nido P.J.
        • Vasilyev N.V.
        Management of systemic right ventricular failure in patients with congenitally corrected transposition of the great arteries.
        Circulation. 2016; 134: 1293-1302
        • Feldman T.
        • Kar S.
        • Elmariah S.
        • Smart S.C.
        • Trento A.
        • Siegel R.J.
        • Apruzzese P.
        • Fail P.
        • Rinaldi M.J.
        • Smalling R.W.
        • Hermiller J.B.
        • Heimansohn D.
        • Gray W.A.
        • Grayburn P.A.
        • Mack M.J.
        • et al.
        Randomized comparison of percutaneous repair and surgery for mitral regurgitation: 5-year results of EVEREST II.
        J Am Coll Cardiol. 2015; 66: 2844-2854
        • Franzen O.
        • von Samson P.
        • Dodge-Khatami A.
        • Geffert G.
        • Baldus S.
        Percutaneous edge-to-edge repair of tricuspid regurgitation in congenitally corrected transposition of the great arteries.
        Congenit Heart Dis. 2011; 6: 57-59
        • Nickenig G.
        • Kowalski M.
        • Hausleiter J.
        • Braun D.
        • Schofer J.
        • Yzeiraj E.
        • Rudolph V.
        • Friedrichs K.
        • Maisano F.
        • Taramasso M.
        • Fam N.
        • Bianchi G.
        • Bedogni F.
        • Denti P.
        • Alfieri O.
        • et al.
        Transcatheter treatment of severe tricuspid regurgitation with the edge-to-edge MitraClip technique.
        Circulation. 2017; 135: 1802-1814
        • Said S.M.
        • Burkhart H.M.
        • Schaff H.V.
        • Dearani J.A.
        Congenitally corrected transposition of great arteries: surgical options for the failing right ventricle and/or severe tricuspid regurgitation.
        World J Pediatr Congenit Heart Surg. 2011; 2: 64-79
        • Riggs K.W.
        • Fukushima S.
        • Fujita T.
        • Rizwan R.
        • Morales D.L.S.
        Mechanical support for patients with congenitally corrected transposition of the great arteries and end-stage ventricular dysfunction.
        Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2019; 22: 66-73
        • Picard F.
        • Tadros V.X.
        • Asgar A.W.
        From tricuspid to double orifice morphology: percutaneous tricuspid regurgitation repair with the MitraClip device in congenitally corrected-transposition of great arteries.
        Catheter Cardiovasc Interv. 2017; 90: 432-436
        • Benito-Gonzalez T.
        • Estevez-Loureiro R.
        • Villablanca P.A.
        • Armeni P.
        • Iglesias-Garriz I.
        • Minguito C.
        • Garrote C.
        • de Prado A.P.
        • Tundidor-Sanz E.
        • Gualis J.
        • Fernandez-Vazquez F.
        Percutaneous mitral valve repair vs. stand-alone medical therapy in patients with functional mitral regurgitation and heart failure.
        Cardiovasc Revasc Med. 2020; 21: 52-60
        • Paranskaya L.
        • D'Ancona G.
        • Bozdag-Turan I.
        • Akin I.
        • Kische S.
        • Turan G.R.
        • Rehders T.
        • Ortak J.
        • Nienaber C.A.
        • Ince H.
        Residual mitral valve regurgitation after percutaneous mitral valve repair with the MitraClip(R) system is a risk factor for adverse one-year outcome.
        Catheter Cardiovasc Interv. 2013; 81: 609-617