Transesophageal Echocardiography–Guided Percutaneous Intervention for a Mitral Valve Leaflet Perforation

A 67-year-old woman with coronary artery disease, peripheral vascular disease, and end-stage renal disease on hemodialysis presented with refractory decompensated congestive heart failure. Echocardiography showed severe mitral regurgitation from 2 sources: poor leaflet coaptation due to tethering of