Abstract
A 33-year-old man with unrepaired tetralogy of Fallot, Eisenmenger syndrome, and torrential aortic regurgitation secondary to previous Streptococcus mitis endocarditis (now sterilized) presented to a local hospital with recurrent decompensated heart failure. Gated computed tomography demonstrated no calcification and an annulus area of 1328 mm(2). The patient's anatomy included an overriding aorta and a large ventriculoseptal defect, allowing for antegrade delivery of a MitraClip NT, which was successfully implanted between the right and noncoronary cusps. Final transesophogeal echocardiography showed diminished aortic regurgitation with a reduction in 3-dimensional vena contracta area from 0.37 to 0.11 cm(2).