Transapical mitral valve implantation after unclipping of a MitraClip: A glimpse into the future and treatment considerations in mitral regurgitation

Danny Dvir, Anson Cheung, Robert Boone, Jonathon Leipsic, Philipp Blanke, Gidon Perlman, Robert Moss, Mustafa Toma, Dion Stub, Shmuel Banai, John Webb

Research output: Contribution to journalArticleOtherpeer-review

2 Citations (Scopus)

Abstract

Aims: Transcatheter mitral valve implantation (TMVI) is a novel approach that may enable a less invasive effective reduction of mitral regurgitation (MR). A limitation of the MitraClip is that definitive implantation of a clip precludes future therapy with TMVI. The purpose of this paper is to describe contemporary treatment considerations in patients with mitral valve regurgitation. Methods and results: In this report we describe an attempted MitraClip implantation which resulted in no reduction of MR severity. There was a consensus that additional clips would probably not be effective. MitraClip implantation was therefore abandoned and the clip was removed, allowing subsequent successful TMVI with the Tiara™ system three weeks later. Echocardiography revealed secure seating of the prosthesis with good mitral valve function, trivial paravalvular leakage and transvalvular gradient of 3 mmHg. The patient recovered rapidly and was discharged four days post implant. Conclusions: The clinical approach towards high-risk patients with significant MR may change in the next few years. In selected patients, in whom an initial attempt with MitraClip implantation results in only limited efficacy, the clip may be retrieved during the index procedure to allow subsequent TMVI.

Original languageEnglish
Pages (from-to)e244-e249
Number of pages6
JournalEuroIntervention
Volume12
Issue number2
DOIs
Publication statusPublished - 1 Jun 2016
Externally publishedYes

Keywords

  • MitraClip
  • Mitral valve regurgitation
  • Transcatheter mitral valve implantation

Cite this

Dvir, D., Cheung, A., Boone, R., Leipsic, J., Blanke, P., Perlman, G., Moss, R., Toma, M., Stub, D., Banai, S., & Webb, J. (2016). Transapical mitral valve implantation after unclipping of a MitraClip: A glimpse into the future and treatment considerations in mitral regurgitation. EuroIntervention, 12(2), e244-e249. https://doi.org/10.4244/EIJV12I2A38