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Edge-to-edge mitral repair for iatrogenic chordal rupture related to Impella 5.0
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  • Hiroto Kitahara,
  • Samer Najjar,
  • Sara Ahmed,
  • Phillip Lam,
  • Ajay Kadakkal,
  • Maria Rodrigo,
  • Mark Hofmeyer,
  • Farooq Sheikh,
  • Ezequiel Molina
Hiroto Kitahara
MedStar Washington Hospital Center

Corresponding Author:kthrhrt11@gmail.com

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Samer Najjar
MedStar Washington Hospital Center
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Sara Ahmed
MedStar Washington Hospital Center
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Phillip Lam
MedStar Washington Hospital Center
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Ajay Kadakkal
MedStar Washington Hospital Center
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Maria Rodrigo
MedStar Washington Hospital Center
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Mark Hofmeyer
MedStar Washington Hospital Center
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Farooq Sheikh
MedStar Washington Hospital Center
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Ezequiel Molina
MedStar Washington Hospital Center
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Abstract

Iatrogenic chordal rupture with severe mitral regurgitation is a rare but serious complication associated with the use of Impella device. We present a case of a 47-year-old man with ischemic cardiomyopathy who presented in cardiogenic shock requiring insertion of extracorporeal membrane oxygenation which was subsequently transitioned to an Impella 5.0 device. During Impella support, he developed acute pulmonary edema secondary to newly diagnosed posterior mitral valve chordal rupture and subsequent severe mitral regurgitation. He underwent implantation of a durable left ventricular assist device with concomitant edge-to-edge mitral valve repair through the apex. Transthoracic echocardiography at three month showed mild regurgitation.