Transcatheter edge-to-edge repair for post-surgical recurrent mitral regurgitation in hereditary spherocytosis: a case report

TL;DR

A patient with hereditary spherocytosis successfully underwent a minimally invasive heart procedure to treat recurring mitral regurgitation after surgery.

Contribution

This case report presents a novel treatment strategy using transcatheter edge-to-edge repair for recurrent mitral regurgitation in hereditary spherocytosis.

Findings

Transcatheter edge-to-edge repair reduced mitral regurgitation without causing haemolysis.

The patient maintained stable moderate MR and improved functional status at 5-year follow-up.

The combined surgical and transcatheter approach may be viable for inherited haemolytic disorders.

Abstract

Management of mitral regurgitation (MR) in patients with hereditary spherocytosis (HS) poses unique challenges due to increased haemolysis risk. While surgical mitral valve repair is the standard treatment, the optimal strategy for recurrent MR after initial repair remains unclear, particularly regarding the safety and durability of transcatheter interventions in this high-risk population.

A 57-year-old woman with HS developed severe recurrent MR 4 years after initial surgical repair that intentionally omitted annuloplasty to minimize haemolysis risk. Given the risks of redo surgery and mechanical valve replacement, mitral valve transcatheter edge-to-edge repair (M-TEER) was performed. The procedure achieved successful MR reduction without causing haemolysis. At the 5-year follow-up, the patient maintained improved functional status with stable moderate MR and no evidence of haemolysis, despite her underlying condition.

This case demonstrates successful long-term outcomes of M-TEER for post-surgical recurrent MR in a patient with HS. The strategic approach—initial ring-less surgical repair followed by M-TEER—suggests a viable treatment pathway for patients with inherited haemolytic disorders, particularly when minimizing prosthetic material exposure is crucial.

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