Iatrogenic chordal rupture with severe mitral regurgitation is a rare
but serious complication associated with the use of Impella device. We
present a case of a 47-year-old man with ischemic cardiomyopathy who
presented in cardiogenic shock requiring insertion of extracorporeal
membrane oxygenation which was subsequently transitioned to an Impella
5.0 device. During Impella support, he developed acute pulmonary edema
secondary to newly diagnosed posterior mitral valve chordal rupture and
subsequent severe mitral regurgitation. He underwent implantation of a
durable left ventricular assist device with concomitant edge-to-edge
mitral valve repair through the apex. Transthoracic echocardiography at
three month showed mild regurgitation.