Delayed Device Embolization After TEER of the Mitral Valve as a Rare But Dangerous Complication.

Background: Delayed device embolization is a rare but dangerous complication after transcatheter edge-to-edge repair (TEER).

Case Summary: A 79-year-old man with acute decompensated severe structural mitral regurgitation underwent TEER with 2 clips after failed medical attempts at recompensation. Six days later, 1 clip embolized into the abdominal aorta, resulting in recurrent, progressive decompensation and severe mitral regurgitation, requiring urgent mitral valve replacement. Despite initial stabilization, the patient died because of septic complications.

Discussion: Although delayed device embolization is rare, it may be underreported in the current literature and can have serious consequences. This underscores the importance of careful heart team evaluation when choosing between interventional vs surgical strategies.

Take-home Message: Device embolization after TEER must be discussed as a rare but serious complication, and particular attention should be given to close post-TEER monitoring, especially in patients with complex anatomy.