Abstract
BACKGROUND: Transcatheter edge-to-edge repair (TEER) has been established as a safe and effective option for treating patients with severe symptomatic degenerative mitral regurgitation (MR) who are at high surgical risk. CASE SUMMARY: This paper presents a case of a 74-year-old male patient with severe MR accompanied with wide prolapse and large flail, treated using an innovative TEER system, GeminiOne, and ventricular pacing. Postoperative echocardiography demonstrated a significant reduction in MR. DISCUSSION: This case report highlights the successful use of the GeminiOne TEER system to treat severe MR with complex anatomical challenge. The innovative use of ventricular pacing for leaflet capture can be valuable for managing complex mitral valve pathologies in high-risk patients. TAKE-HOME MESSAGE: This case highlights the safety and efficacy of the device and introduces a novel leaflet capture strategy.