Percutaneous Atrioventricular Valve Repair With MitraClip in Failed Adult Fontan Circulation for Tricuspid Atresia

A 60-year-old woman with tricuspid atresia had previously undergone palliation with a Glenn procedure and a Blalock-Taussig shunt, and finally correction with a Fontan procedure. Twenty-five years later, severe atrioventricular valve regurgitation with concomitant valvular prolapse and cleft leading to heart failure was successfully treated using 1 single MitraClip XTW, confirming its effectiveness as a lower-risk alternative to surgery. The patient showed marked improvement of heart failure–related symptoms, with residual mild to moderate regurgitation and improved liver function.