Abstract
We present the case of a 76-year-old man with a previous history of surgical aortic valve replacement 3 years earlier for infective endocarditis, nonischemic cardiomyopathy, and severe secondary mitral regurgitation (SMR) who presented with worsening dyspnea on exertion. Echocardiography revealed severe SMR and a perforation at the base of the A1 scallop of the anterior mitral valve leaflet (AMVL). The patient was deemed at high surgical risk. After multidisciplinary team discussion, we proceeded with mitral transcatheter edge to edge repair with 2 MitraClips (Abbott) and concomitant transcatheter closure of the perforation of the AMVL with an Amplatzer Duct Occluder II (Abbott) device.