Transcatheter Mitral Edge-to-edge Repair in Patients with Transthyretin Cardiac Amyloidosis: A Four-case Series.
Ayaka Ujita, Masayoshi Yamamoto, Tomoya Hoshi et al.
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Case in brief
Four patients with transthyretin cardiac amyloidosis and mitral regurgitation underwent transcatheter edge-to-edge repair (TEER). Mitral regurgitation was reduced in all four, but recurrent worsening occurred in one patient. Two patients died within one year. The report notes that longer-term outcomes appeared poor in the setting of amyloidosis progression or comorbidities, despite the reduction in regurgitation.
What made this case unusual
All four patients had reduced mitral regurgitation after TEER, yet early deaths and recurrent regurgitation highlighted the gap between procedural improvement and longer-term outcomes in this clinical context.
Diagnostic / clinical pearl
In transthyretin cardiac amyloidosis, TEER may reduce mitral regurgitation, but procedural success does not ensure favorable longer-term outcomes; assess disease progression and comorbidities when selecting patients.