Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-215
MitraClip Single-Leaflet Detachment and Consequent Migration in Atrial Functional Mitral Regurgitation
By Yong-Joon Lee
Presenter
Yong-Joon Lee
Authors
Yong-Joon Lee1
Affiliation
Severance Hospital, Korea (Republic of)1,
View Study Report
TCTAP C-215
Structural - Mitral Valve Intervention - TEER
MitraClip Single-Leaflet Detachment and Consequent Migration in Atrial Functional Mitral Regurgitation
Yong-Joon Lee1
Severance Hospital, Korea (Republic of)1,
Clinical Information
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
84-year-old female with symptomatic severe functional mitral regurgitation (MR) due to long standing atrial fibrillation underwent transcatheter edge-to-edge repair using the MitraClip system. After deployment of an XTR clip in the A2-P2segment, a second MitraClip XT device was deployed laterally to prevent recurrence of MR due to stretching of left atrium and mitral leaflets. However, single leaflet detachment of the anteriorleaflet occurred immediately.
Relevant Test Results Prior to Catheterization
Since only mild MR was observed after theprocedure, additional clipping was not performed. However, at two weeks after discharge, the patientpresented with right inguinal pain and aggravated symptoms of dyspnea.Thelateral clip was not observed on chest x-ray. Computed tomography revealed themigrated MitraClip at the bifurcation of right common iliac artery. Transesophagealechocardiography (TEE) showed recurrence of severe MR with small chordae rupture.
Relevant Catheterization Findings
Peripheral angiography revealed embolized clip at Rt common iliac artery bifurcation site.
Interventional Management
Procedural Step
The embolized MitraClip was successfully retrieved using 10mm and 15mm Amplatz GooseNeck® snares (Ev3, Plymouth, MN, USA) through a 16-French Check-Flo® Introducer sheath (Cook Medical, Bloomington, IN, USA),and another NTW clip was successfully deployed. Post-procedure TEE confirmed residual mild to moderate MR. Images from this case show the complications of MitraClip single leaflet detachment and distal migration to lower-extremityartery, and how this problem was successfully solved by intervention.
Case Summary
MitraClip single-leaflet detachment and consequent migration in common iliac artery was succefully managed with percutaenous intervention with re-do MitraClip and retrieval of emolized clip with snares without any complications.