Fully percutaneous emergency management of an acute myocardial infarction complicated by papillary muscle rupture treated with percutaneous revascularization and mitral transcatheter edge-to-edge repair: a case report.

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ID: 315523
2026
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Abstract
Abstract Background papillary muscle rupture (PMR) in a rare and life-threatening complication of a myocardial infarction (MI). In our case we describe a complete percutaneous emergency management of this complication with coronary angioplasty followed to successful MitraClip repair. Case Summary we report a case of a 62-years-old man with MI and severe mitral regurgitation. We performed percutaneous revascularization and intra-aortic balloon pump was placed (IABP). After a transthoracic and transesophageal echo evaluation a PMR was diagnosed. Due to intractable pulmonary oedema, we proceed to emergency mitral edge-to-edge repair with two MitraClip just two hours later. Mitral regurgitation was reduced to mild and patient was estubated. Conclusion this case reports a completely percutaneous management of a MI complicated by PMR in prohibitive surgical risk patient. Emergency treatment of MI and PMR with coronary angioplasty and MitraClip is feasible and could be a bail-out option in high surgical risk patients.
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Authors Mauro Pennacchi, Francesco De Felice, A Pergolini, Annachiara Pingitore, Domenico Gabrielli
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag407
URL
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