MitraClip™ implantation plus left atrial appendage occlusion in a hereditary hemorrhagic telangiectasia patient.

ABSTRACT

Hereditary hemorrhagic telangiectasia is regarded as a high hemorrhagic risk condition, and the management of anticoagulation and heart surgery in these patients can be challenging. The authors describe a combined percutaneous treatment of mitral regurgitation and left atrial appendage occlusion in a patient affected by hereditary hemorrhagic telangiectasia and atrial fibrillation, supporting the safety and feasibility of the procedure and the optimal short-term outcome.

Hereditary hemorrhagic telangiectasia is a disease that carries a high risk of bleeding because of the growth of blood vessels with weak walls. The authors describe the case of a patient with hereditary hemorrhagic telangiectasia needing an intervention for mitral valve regurgitation and anticoagulation therapy for atrial fibrillation. To reduce the bleeding risk, two innovative techniques were used the mitral valve disease was treated with the percutaneous implantation of stitches without open chest surgery and the left atrial appendage was contextually occluded thanks to another mini-invasive procedure to avoid the need for anticoagulation.