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

Abstract

Background: 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. Case summary: 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. Discussion: 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.