# Iatrogenic non-coronary leaflet perforation as a complication after robotic mitral valve repair

## TL;DR

A rare case of aortic regurgitation caused by leaflet perforation after robotic mitral valve repair is reported for the first time.

## Contribution

This is the first reported case of non-coronary leaflet perforation leading to aortic regurgitation after robotic mitral valve repair.

## Key findings

- A patient developed aortic regurgitation 18 months after robotic mitral valve repair due to non-coronary leaflet perforation.
- The perforation was not detected during surgery or immediately after due to its small size and gradual enlargement.
- The case highlights the potential for delayed diagnosis of aortic regurgitation following mitral valve surgery.

## Abstract

Iatrogenic aortic regurgitation secondary to leaflet injury is a rare complication of mitral valve surgery. For the first time, we report a patient who had progressive aortic regurgitation due to non-coronary leaflet perforation after robotic mitral valve repair and required aortic valve repair 18 months after this initial surgery. As in our case, aortic regurgitation after mitral valve surgery may remain undiagnosed on intraoperative transesophageal echocardiography or undetected until the patient’s discharge due to gradual enlargement of very small perforations over the postoperative course.

The online version contains supplementary material available at 10.1186/s13019-024-02753-4.