Author + information
- Received November 19, 2015
- Accepted December 3, 2015
- Published online April 11, 2016.
- Brinder S. Kanda, MD,
- Desmond Jay, MD,
- R. Saeid Farivar, MD, PhD and
- Paul Sorajja, MD∗ ()
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
- ↵∗Reprint requests and correspondence:
Dr. Paul Sorajja, Center for Valve and Structural Heart Disease, Minneapolis Heart Institute at Abbott Northwestern Hospital, 920 East 28th Street, Minneapolis, Minneapolis 55416.
An 86-year-old man presented with recurrent heart failure and severe mitral regurgitation in the setting of previous surgical mitral repair for degenerative valve disease. Surgery had consisted of placement of a 32-mm Carpentier-Edwards Physio II annuloplasty ring (Edwards Lifesciences, Irvine, California). Transesophageal echocardiography demonstrated a large anterior leaflet (Figure 1A, arrow), poor coaptation of the anterior leaflet with the annuloplasty ring, a markedly deficient posterior leaflet (Figure 1B, arrow), and severe residual mitral regurgitation (Figure 1C, arrow) between the tip of the anterior leaflet and the annuloplasty ring (Figure 1D, arrow). Using a transfemoral, transseptal approach, a MitraClip (Abbott Vascular, Santa Clara, California) (Figures 1E and 1F, arrows) was implanted to affix the anterior leaflet to the annuloplasty ring (Figure 1G, arrow). This implantation led to acute reduction in mitral regurgitation (Figure 1H, arrows). The mean left atrial pressure decreased from 28 mm Hg at baseline (Figure 1I) to 21 mm Hg at the end of the procedure (Figure 1J). There was relief of heart failure symptoms, and the MitraClip procedure obviated the need for repeat cardiac surgery. To our knowledge, this description represents the first report of MitraClip implantation for fixation of native leaflets onto a surgical annuloplasty ring.
Dr. Farivar is a consultant for Edwards Lifesciences and Abbott Vascular. Dr. Sorajja is a consultant for and on the speakers bureau for Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 19, 2015.
- Accepted December 3, 2015.
- American College of Cardiology Foundation