Successful Transcatheter Mitral Valve Repair for Iatrogenic Chordal Rupture in Cardiac Amyloidosis.

Daisuke Kanda, Yoshihisa Horizoe, Akari Tajima, Hiroyuki Tabata, Youta Uchiyama, Mitsuru Ohishi

Abstract readCase Reports

In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Daisuke KandaDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. Electronic address: kanchan@m3.kufm.kagoshima-u.ac.jp.

Yoshihisa HorizoeDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

Akari TajimaDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

Hiroyuki TabataDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

Youta UchiyamaDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

Mitsuru OhishiDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac amyloidosis is associated with poor prognosis. Biopsy-induced severe mitral regurgitation (MR) secondary to chordal rupture is a rare but critical complication, and its optimal management remains uncertain. CASE SUMMARY: A 78-year-old man with transthyretin cardiac amyloidosis developed acute severe MR after left ventricular myocardial biopsy, which caused rupture of the chordae tendineae. He presented with NYHA functional class IV heart failure. Given his condition, transcatheter edge-to-edge mitral valve repair (M-TEER) was prioritized. A MitraClip was successfully deployed, reducing the severe MR to mild without complications, and his symptoms markedly improved. DISCUSSION: This is to our knowledge the first reported case of biopsy-induced MR in cardiac amyloidosis successfully managed using M-TEER. This case demonstrates the safety and efficacy of M-TEER in frail patients with iatrogenic mechanical complications. TAKE-HOME MESSAGE: M-TEER may be a life-saving therapy for severe iatrogenic MR in patients with advanced cardiac amyloidosis.

Indexed as

cardiac amyloidosischordae tendineae ruptureleft ventricular endomyocardial biopsyMitraClipmitral regurgitationstructural heart intervention

Identifiers

PMID41269195

DOI10.1016/j.jaccas.2025.106137

PMCPMC12926075

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