Emergency mitral valve transcatheter edge-to-edge repair in cardiogenic shock due to papillary muscle rupture.

Usman Ahmed, Christopher Kim, Camila Machado De Souza, Fatima Noor, Roger Laham, David C Liu, Feroze Mahmood

Abstract readCase Reports

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Article in Journal of cardiology cases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed

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1 citing paper in PubMed.

Temporary Mechanical Circulatory Support in Patients in Cardiogenic Shock Requiring Cardiac Surgery: Protected Cardiac Surgery Concept.Journal of clinical medicine · 2026
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5 · Who and what money

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7 authors.

Usman AhmedDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Christopher KimDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Camila Machado De SouzaDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Fatima NoorDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Roger LahamDivision of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

David C LiuDepartment of Thoracic and Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Feroze MahmoodDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cardiogenic shock secondary to papillary muscle rupture carries high mortality and often precludes surgical repair. We present a case of acute mitral regurgitation following myocardial infarction managed with emergent transcatheter edge-to-edge repair (TEER) under combined veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and transvalvular assist device (Impella, Abiomed, Danvers, MA, USA) support. Real-time echocardiographic guidance required transient VA-ECMO flow reduction to optimize right atrial visualization and Impella adjustment to prevent device interference. Sequential clip deployment achieved significant mitral regurgitation reduction and hemodynamic improvement. This case highlights the feasibility, imaging challenges, and multidisciplinary coordination required for successful TEER in refractory cardiogenic shock. Learning objective: We illustrate the feasibility and technical nuances of performing transcatheter edge-to-edge mitral valve repair in cardiogenic shock due to papillary muscle rupture under combined veno-arterial extracorporeal membrane oxygenation and Impella support. This case emphasizes the critical role of real-time multimodality echocardiographic guidance, hemodynamic optimization through temporary device flow adjustments, and coordinated multidisciplinary decision-making in achieving procedural success when conventional surgical repair is not feasible.

Indexed as

Cardiogenic shockImpellaMitral regurgitationPapillary muscle ruptureTranscatheter edge-to-edge repairVeno-arterial extracorporeal membrane oxygenation

Identifiers

PMID42254041

DOI10.1016/j.jccase.2026.02.002

PMCPMC13241984

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