{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T03:00:13Z","timestamp":1768618813897,"version":"3.49.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Severe mitral regurgitation (MR) through the body of the anterior mitral leaflet (AML) is rare. The cause either iatrogenic during open-heart surgery or due to infective endocarditis. We present a case where a successful percutaneous closure of the AML perforation was an alternative to surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 60-year-old male presented with shortness of breath (SOB) class III of 12 months duration. He underwent coronary artery bypass surgery with four grafts plus mitral valve (MV) repair 20 months ago. Transthoracic echocardiogram (TTE) and transoesophageal echocardiogram (TOE) revealed severe MR through the body of AML at A3. The percutaneous closure plan was to cross the AML perforation from the left ventricular side. The venacontracta of the perforation was 6 mm, an amplatzer septal occluder device 6 mm considered appropriate for closure of this hole. A snare catheter snared the wire and exteriorized creating arteriovenous loop. Amplatzer septal occluder 6 mm loaded to the delivery system till larger disc (left-sided) opened safely and freely below the MV apparatus. Once the left ventricular side disc opposed the ventricular surface of AML, the waist and left atrial disc gently released. The patient discharged in the next day. After 6 months, the patient had no more SOB, he returned to his daily activity. Follow-up TTE showed no MR, the closure device was stable in place.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>We added a successful case of transcatheter AML perforation to the literature. The role of TOE is crucial in diagnosis and procedure guidance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa142","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T23:36:54Z","timestamp":1595288214000},"page":"1-5","source":"Crossref","is-referenced-by-count":5,"title":["Percutaneous closure of iatrogenic anterior mitral leaflet perforation: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3780-6262","authenticated-orcid":false,"given":"Hesham Abdo","family":"Naeim","sequence":"first","affiliation":[{"name":"Madinah Cardiac Center, Adult Cardiology Department, Khaled Bin Waleed Street, PO 6167, Madinah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama","family":"Amoudi","sequence":"additional","affiliation":[{"name":"Madinah Cardiac Center, Adult Cardiology Department, Khaled Bin Waleed Street, PO 6167, Madinah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abeer","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Madinah Cardiac Center, Adult Cardiology Department, Khaled Bin Waleed Street, PO 6167, Madinah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6232-169X","authenticated-orcid":false,"given":"Reda","family":"Abuelatta","sequence":"additional","affiliation":[{"name":"Madinah Cardiac Center, Adult Cardiology Department, Khaled Bin Waleed Street, PO 6167, Madinah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,7,20]]},"reference":[{"key":"2020101507151797500_ytaa142-B1","doi-asserted-by":"crossref","first-page":"234","DOI":"10.12945\/j.jshd.2018.002.18","article-title":"Transcatheter repair of anterior mitral leaflet perforation in a patient with mechanical aortic valve using antegrade and retrograde approaches","volume":"4","author":"Abuelatta","year":"2018","journal-title":"J Struct Heart Dis"},{"key":"2020101507151797500_ytaa142-B2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S0894-7317(14)80553-1","article-title":"Perforation of the anterior mitral leaflet caused by aortic valve endocarditis: diagnosis by two-dimensional, transesophageal echocardiography and color flow Doppler","volume":"5","author":"Nomeir","year":"1992","journal-title":"J Am Soc Echocardiogr"},{"key":"2020101507151797500_ytaa142-B3","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.jtcvs.2009.07.040","article-title":"Safety and durability of mitral valve repair for anterior leaflet perforation","volume":"139","author":"Sareyyupoglu","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020101507151797500_ytaa142-B4","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S0300-8932(10)70121-4","article-title":"Percutaneous closure of a native mitral valve perforation","volume":"63","author":"Velasco","year":"2010","journal-title":"Rev Esp Cardiol"},{"key":"2020101507151797500_ytaa142-B5","first-page":"134","article-title":"Percutaneous repair of anterior mitral leaflet perforation","volume":"24","author":"Javed","year":"2012","journal-title":"J Invasive Cardiol"},{"key":"2020101507151797500_ytaa142-B6","first-page":"274","article-title":"First report of percutaneous closure of anterior mitral leaflet perforation using a paravalvular leak device (PLD)","volume":"3","author":"Raczkiewicz","year":"2016","journal-title":"Postepy Kardiol Interwencyjnej"},{"key":"2020101507151797500_ytaa142-B7","doi-asserted-by":"crossref","first-page":"312","DOI":"10.4103\/apc.APC_162_18","article-title":"Retrograde transcatheter closure of anterior mitral valve leaflet perforation","volume":"12","author":"Sengun","year":"2019","journal-title":"Ann Pediatr Card"},{"key":"2020101507151797500_ytaa142-B8","doi-asserted-by":"crossref","first-page":"e1302","DOI":"10.4244\/EIJV11I11A252","article-title":"A creative transcatheter approach to correct complex recurring mitral regurgitation after previous surgical repair","volume":"11","author":"Czerny","year":"2016","journal-title":"EuroIntervention"}],"container-title":["European Heart Journal - 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