Transcatheter Edge-to-Edge Repair for Severe Acute Mitral Valve Regurgitation in Diffuse Alveolar Hemorrhage - Case Report

Sep 29, 2026

Uploaded by moss~

Severe acute mitral valve regurgitation can rarely coexist with diffuse alveolar hemorrhage, creating complex diagnostic and therapeutic challenges, especially when anticoagulation is required. This case report describes a 66-year-old woman with dyspnea and hemoptysis, whose imaging confirmed diffuse alveolar hemorrhage and whose echocardiography showed acute severe mitral regurgitation. The patient underwent transcatheter edge-to-edge repair (TEER) using the Pascal device after initial preference over surgery. Recurrent mitral regurgitation and persistent pulmonary hemorrhage led to clinical deterioration and death despite intensive management and supportive care.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Case Report

Conclusions

e-ISSN 1941-5923 © Am J Case Rep, 2025; 26: e949953 DOI: 10. 12659/AJCR.949953 Received: 2025.05.22 Accepted: 2025.09.11 Available online: 2025.11.06 Published: 2025.12.04 Authors’ Contribution: Study Design A Data Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G AEF AEF ABEF EF ABCDEF ABCDEFG DEF Corresponding Author: Financial support: Conflict of interest: 1 1 1 2 2 2 2 Transcatheter Edge-to-Edge Repair for Severe Acute Mitral Valve Regurgitation in Diffuse Alveolar Hemorrhage: A Case Report Jasmine K. Dugal Vasiliki Tasouli-Drakou Arpinder S. Malhi Divyansh Sharma Ryan Shao Kachon Lei Ahsan Chowdhury Jasmine K. Dugal, [e-mail:](e-mail: jasmine.dugal@unlv.edu)[ jasmine.dugal@unlv.edu](e-mail: jasmine.dugal@unlv.edu)[ ](e-mail: jasmine.dugal@unlv.edu)None declared None declared 1 Department of Internal Medicine, University of Nevada, Las Vegas, NV, USA 2 Department of Cardiovascular Medicine, University of Nevada, Las Vegas, NV, USA Patient: Female, 66-year-old Final Diagnosis: Diffuse alveolar hemorrhage Symptoms: Dyspnea Clinical Procedure: — Specialty: Cardiology Objective: Management of emergency care Background: Diffuse alveolar hemorrhage is rarely associated with acute mitral valve regurgitation. Emerging evidence of transcatheter edge-to-edge repair (TEER) use for treating acute mitral regurgitation has promoted TEER as a promising alternative to mitral valve surgery, owing to reduced mortality and complications. Case Report: A 66-year-old female patient with a history of thyroid nodules presented with dyspnea and hemoptysis. Imaging confirmed bilateral pleural effusions, with opacities suggestive of diffuse alveolar hemorrhage, and echocardiography revealed acute severe mitral valve regurgitation. The patient chose TEER over surgical valve replacement. After discharge on apixaban for new-onset atrial fibrillation, she returned a week later with melena and worsening dyspnea. Echocardiography demonstrated recurrent mitral valve regurgitation, and bronchoscopy confirmed diffuse alveolar hemorrhage. Despite aggressive management, the patient died. Conclusions: This case highlights the complexity of managing acute severe mitral regurgitation complicated by diffuse alveolar hemorrhage in a patient requiring anticoagulation. Although a TEER procedure using the Pascal device was performed, the patient’s condition continued to deteriorate, underscoring the importance of individualized treatment strategies, as surgical mitral valve replacement may offer more definitive hemodynamic correction in selected cases. Keywords: Cardiovascular Diseases • Dyspnea • Hemorrhage Full-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/949953](https://www.amjcaserep.com/abstract/index/idArt/949953) 2607 — 4 14 Publisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher This work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) e949953-1 Indexed in: [PMC] [PubMed] [Emerging Sources Citation Index (ESCI)][Web of Science by Clarivate] Dugal [J.K. et](J.K. et) al: Transcatheter edge-to-edge repair for acute mitral regurgitation © Am J Case Rep, 2025; 26: e949953 Introduction Diffuse alveolar hemorrhage (DAH) is a life-threatening pulmonary condition widely seen in hematologic malignancies and systemic autoimmune disorders; it has also been reported in patients taking anticoagulants or certain medications, such as amiodarone and nitrofurantoin [1]. DAH is characterized by intra-alveolar bleeding originating f

FAQs

What condition was identified as the final diagnosis in this case?

Diffuse alveolar hemorrhage was established as the final diagnosis after bronchoscopy confirmed intra-alveolar bleeding.

Why did management become especially complex after TEER?

The patient required anticoagulation for new-onset atrial fibrillation, while TEER did not prevent recurrent mitral regurgitation and worsening diffuse alveolar hemorrhage.

What treatment did the patient choose instead of surgical valve replacement?

The patient chose transcatheter edge-to-edge repair (TEER) for acute severe mitral regurgitation.

Sep 29, 2026

Uploaded by moss~