Bileaflet Tethering With Preserved LV Geometry and Function: An Unusual Mechanism of Functional Mitral Regurgitation

Dario Donia; Kamil Stankowski; Stefano Figliozzi; Carlo Andrea Pivato; Damiano Regazzoli; Antonio Mangieri; Bernhard Reimers; Renato Maria Bragato; Giulio Stefanini; Francesco Cannata

doi:10.1016/j.jaccas.2023.102191

Bileaflet Tethering With Preserved LV Geometry and Function: An Unusual Mechanism of Functional Mitral Regurgitation

JACC Case Rep. 2023 Dec 30;29(3):102191. doi: 10.1016/j.jaccas.2023.102191. eCollection 2024 Feb 7.

Authors

Dario Donia^{1

2}, Kamil Stankowski^{1

2}, Stefano Figliozzi², Carlo Andrea Pivato^{1

2}, Damiano Regazzoli², Antonio Mangieri², Bernhard Reimers², Renato Maria Bragato², Giulio Stefanini^{1

2}, Francesco Cannata^{2

3}

Affiliations

¹ Department of Biomedical Sciences, Humanitas University, Milan, Italy.
² IRCCS Humanitas Research Hospital, Milan, Italy.
³ Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy.

Abstract

An 81-year-old woman presented with acute pulmonary edema. Echocardiography revealed severe functional mitral regurgitation, the mechanism of which was unusual. An atypical bileaflet tethering caused by disharmonic annular remodeling, concomitant aortic dilatation, and reduced aorto-mitral angle without left ventricular dysfunction or dilatation was found. A transcatheter edge-to-edge repair was nonetheless successfully performed.

Keywords: 3-dimensional echocardiography; bileaflet tethering; functional mitral regurgitation; transcatheter edge-to-edge repair; transesophageal echocardiography.

Publication types

Case Reports