An 81-year-old man with progressive breathlessness was treated for complex coronary and valvular disease at a civic-run hospital in Mumbai, avoiding the risks associated with conventional open-heart surgery. The patient had severe mitral regurgitation along with significant disease involving all three major coronary arteries. Given his advanced age and frailty, the cardiology team considered a staged catheter-based approach instead of proceeding directly with bypass surgery and surgical mitral valve intervention. He first underwent angioplasty for two coronary artery blockages.

Seven days later, the team performed mitral transcatheter edge-to-edge repair (M-TEER), using a catheter-based clip to approximate the mitral valve leaflets and reduce regurgitation. The procedures were performed one week apart, allowing the coronary disease to be addressed before the valve intervention. The…