Hypoxia Following Mitral Transcatheter Edge-to-Edge Repair: Iatrogenic Fistula.

BACKGROUND: Mitral regurgitation (MR) is a common disorder associated with increased risk of morbidity and mortality. Transcatheter edge-to-edge repair (TEER) is a minimally invasive option that is increasingly used in the management of this condition. Randomized controlled trials have concluded that TEER is safe and effective in reducing secondary MR. CASE SUMMARY: An 81-year-old woman underwent mitral TEER for severe secondary MR. She suffered from ongoing hypoxia postprocedure because of an iatrogenic fistula between the right main pulmonary artery and left atrium with right to left shunt. DISCUSSION: This case represents a unique and rare complication of mitral TEER. TAKE-HOME MESSAGES: Rare but life-threatening complications of mitral TEER should be recognized in a timely manner. Finally, clinicians should consider filter-based cerebral protection system during TEER; however, further studies on its utility are warranted.