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Review of 'Failed MitraClip-procedure with pull out of the anterior leaflet'

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Failed MitraClip-procedure with pull out of the anterior leaflet

 Michael Gross,  ,  Susanne Rutschow (corresponding) (2014)
Abstract: MitraClip is an attractive and less invasive alternative to mitral valve surgery in serve mitral regurgitation in patients with moderate or severe risk for operation. It has been described to be effective and safe in functional as well as in degenerative mitral regurgitation. We report a case of MitraClip procedure with the pull out of the anterior leaflet during the intervention. The patient underwent cardiopulmonary support and surgical intervention with a good outcome. With this report we illustrated the etiology and management of this complication.
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    Review information

    10.14293/S2199-1006.1.SOR-MED.AQBXG3.v1.RXJKWB

    This work has been published open access under Creative Commons Attribution License CC BY 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com.

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    Review text

    his is an interesting paper reporting an intra-procedural partial clip detachment from the AML.
    The case is well presented and it seems to me that it was ideal for MitraClip. I would like to stress the importance of confirming that adequate leaflet insertion is mandatory before releasing the clip. However, I disagree with authors that the procedure should be stopped at this point. Usually the placement of a second or third clip can stabilize the first one and achieve an optimal result. Readers must be aware that the presence of partial clip detachment is not an indication for conversion to stander surgery, that, as reported in the case, is associated with high morbidity.

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