biostudies-literatureUnknown30(22)Betti M<h4>Background</h4>Transapical transcatheter aortic valve replacement (TA-TAVR) is a viable option for inoperable patients who are not eligible for a transfemoral route. Rarely, delayed complications such as primary mitral regurgitation (MR) may emerge owing to procedural factors.<h4>Case summary</h4>An 85-year-old patient deemed at high surgical risk underwent TA-TAVR successfully for severe symptomatic aortic stenosis. Two months after the procedure, he returned with progressive dyspnea secondary to severe MR caused by anterior mitral leaflet flail. Mitral transcatheter edge-to-edge repair (M-TEER) was performed with a significant reduction in MR severity and notable symptomatic improvement.<h4>Discussion</h4>This case describes an unusual late-onset complication of TA-TAVR. Early recognition and reintervention were key, as M-TEER offered a safe and effective strategy for treating this atypical complication.<h4>Take-home message</h4>Severe primary MR can be a complication of TA-TAVR that may not be detectable in the immediate postoperative period, and M-TEER can be a valid option for its treatment.JACC. Case reports104653https://www.ebi.ac.uk/biostudies/studies/S-EPMC12426552biostudies-literatureMitral Transcatheter Edge-to-Edge Repair for Anterior Leaflet Flail Induced by Transapical Transcatheter Aortic Valve Replacement.PMC12426552Kats STheunissen RALJStreukens SAFvan 't Hof AWJVriesendorp PAMaesen BVainer JBetti MfalseMitral Transcatheter Edge-to-Edge Repair for Anterior Leaflet Flail Induced by Transapical Transcatheter Aortic Valve Replacement.<h4>Background</h4>Transapical transcatheter aortic valve replacement (TA-TAVR) is a viable option for inoperable patients who are not eligible for a transfemoral route. Rarely, delayed complications such as primary mitral regurgitation (MR) may emerge owing to procedural factors.<h4>Case summary</h4>An 85-year-old patient deemed at high surgical risk underwent TA-TAVR successfully for severe symptomatic aortic stenosis. Two months after the procedure, he returned with progressive dyspnea secondary to severe MR caused by anterior mitral leaflet flail. Mitral transcatheter edge-to-edge repair (M-TEER) was performed with a significant reduction in MR severity and notable symptomatic improvement.<h4>Discussion</h4>This case describes an unusual late-onset complication of TA-TAVR. Early recognition and reintervention were key, as M-TEER offered a safe and effective strategy for treating this atypical complication.<h4>Take-home message</h4>Severe primary MR can be a complication of TA-TAVR that may not be detectable in the immediate postoperative period, and M-TEER can be a valid option for its treatment.2025-01-01T00:00:00Z2025 Aug2026-04-08T19:52:47.207Z2026-04-08T14:35:50.62ZS-EPMC124265524078076510.1016/j.jaccas.2025.104653