Abstract
We report 2 cases of patients who were successfully treated surgically for remaining or recurrent mitral regurgitation after MitraClip (Abbott Vascular, Santa Clara, CA, USA) implantation. In one patient, intervention with MitraClip was indicated because of the extremely poor heart function and poor general status of the patient. However, the severe mitral insufficiency remained after the MitraClip treatment and valve replacement was required. In the other high-risk patient, severe mitral regurgitation recurred 3 years after a successful MitraClip treatment due to infective endocarditis. Our experience suggests that some patients who are considered “high-risk” before MitraClip treatment might be reasonable candidates for a straight forward mitral valve surgery, even in the re-intervention setting. We conclude that patients considered for MitraClip implantation should undergo detailed risk stratification, because we have to keep in mind that after failed clip implantation the perioperative risk increases and the chance of mitral repair decreases.
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Feldman T, Foster E, Glower DD, Kar S, Rinaldi MJ, Fail PS, Smalling RW, Siegel R, Rose GA, Engeron E, Loghin C, Trento A, Skipper E, Fudge T, Letsou GV, Massaro JM, Mauri L. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med. 2011;364:1395–406.
Geidel S, Schmoeckel M. Impact of failed mitral clipping on subsequent mitral valve operations. Ann Thorac Surg. 2014;97:56–63.
Alozie A, Westphal B, Kische S, Kaminski A, Paranskaya L, Bozdag-Turan I, Ortak J, Schubert J, Steinhoff G, Ince H. Surgical revision after percutaneous mitral valve repair by edge-to-edge device: when the strategy fails in the highest risk surgical population. Eur J Cardiothorac Surg. 2013. doi:10.1093/ejcts/ezt535.
Argenziano M, Skipper E, Heimansohn D, Letsou GV, Woo J, Kron I, Alexander J, Cleveland J, Kong B, Davidson M, Vassiliades T, Krieger K, Sako E, Tibi P, Galloway A, Foster E, Feldmann T, Glower D. Surgical revision after percutaneous mitral repair with the MitraClip device. Ann Thorac Surg. 2010;89:72–80.
David TE, Ivanov J, Armstrong S, Rakowski H. Late outcomes of mitral valve repair for floppy valves; implications for asymptomatic patients. J Thorac Cardiovasc Surg. 2003;125:1143–52.
Detaint D, Sundt TM, Nkomo VT, Scott CG, Tajik AJ, Schaff HV, Enriquez-Sarano M. Surgical correction of mitral regurgitation in the elderly: outcomes and recent improvements. Circulation. 2006;114:265–72.
Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2012;42:S1–44.
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Saito and other co-authors have no conflict of interest.
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Saito, S., Baraki, H., Fleischer, B. et al. Mitral valve replacement after failed MitraClip™ therapy: report of two cases. J Artif Organs 18, 177–180 (2015). https://doi.org/10.1007/s10047-014-0814-9
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DOI: https://doi.org/10.1007/s10047-014-0814-9