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<p>A 75-year-old man presented with acute decompensated heart failure due to severe mitral regurgitation caused by central malcoaptation associated with a deep posterior mitral leaflet cleft and a tri-leaflet-like mitral valve configuration. Because of high surgical risk and frailty, transcatheter edge-to-edge repair was performed using the PASCAL Ace system. Initial direct approximation across the cleft caused leaflet distortion and residual mitral regurgitation between A2 and the lateral posterior mitral leaflet. A second device was therefore placed laterally, resulting in a clover-like configuration, reduced mitral regurgitation, and improved left atrial pressure.</p>

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A clover-like repair strategy for posterior mitral leaflet cleft using transcatheter edge-to-edge repair

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月24日

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  • Jo Omiya,
  • Akihisa Kataoka,
  • Kento Kito,
  • Masataka Arakawa,
  • Yusuke Watanabe,
  • Ken Kozuma

摘要

A 75-year-old man presented with acute decompensated heart failure due to severe mitral regurgitation caused by central malcoaptation associated with a deep posterior mitral leaflet cleft and a tri-leaflet-like mitral valve configuration. Because of high surgical risk and frailty, transcatheter edge-to-edge repair was performed using the PASCAL Ace system. Initial direct approximation across the cleft caused leaflet distortion and residual mitral regurgitation between A2 and the lateral posterior mitral leaflet. A second device was therefore placed laterally, resulting in a clover-like configuration, reduced mitral regurgitation, and improved left atrial pressure.