, Volume 39, Issue 8, pp 1016–1018 | Cite as

Unsuccessful MitraClip procedure due to emerging right atrial thrombus and difficult transseptal puncture

Saved by multidimensional transesophageal echocardiography
  • G. Açar
  • S. FidanEmail author
  • A. Avcı
  • E. Alizade
  • A.M. Esen
e-Herz: Case study

Additional material online

This article includes four additional Videos. You will find this supplemental at

Case report

A 68-year-old man who was suffering from progressive dyspnea on mild exertion (New York Heart Association Class III) and decreased functional capacity was referred to our hospital. He had history of coronary artery bypass grafting surgery 10 years ago and diabetes. He was also suffering from concomitant chronic renal disease without the need for dialysis. Both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) revealed severe functional mitral regurgitation between A2–P2 scallops and an ejection fraction around 30 %.The European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the Society of Thoracic Surgeons (STS) risk scoring algorithms used to estimate perioperative risk and operability. His calculated logistic EuroScore was 35 %, and his STS score was 18 %. Thus, mitral valve operation...


Mitral Valve Operation Functional Mitral Regurgitation Transseptal Puncture Logistic EuroScore Cardiac Operative Risk Evaluation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Nach schwieriger transseptaler Punktion und Vorhofthrombusbildung abgebrochene MitraClip-Intervention

Sicherung durch multidimensionale Echokardiographie


Compliance with ethical guidelines

Conflict of interest. G. Açar, S. Fidan, A. Avcı, E. Alizade, and A.M. Esen state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

Supplementary material

Video 1: Two dimensional transesophageal echocardiography showing the difficult transseptal puncture procedure. (AVI 58,9MB)

59_2013_3937_MO2_ESM.avi (22 mb)
Video 2: Three-dimensional transoesophageal echocardiography left atrial view showing stretched interatrial septum. (AVI 21,9MB)

Video 3: Three-dimensional transoesophageal echocardiography right atrial view showing the right atrial thrombus. (AVI 102MB)

Video 4: Two dimensional transesophageal echocardiography showing the cord like structures and the emerging thrombus on cord like structures. (AVI 116MB)

Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  • G. Açar
    • 1
  • S. Fidan
    • 1
    Email author
  • A. Avcı
    • 1
  • E. Alizade
    • 1
  • A.M. Esen
    • 1
  1. 1.Department of CardiologyKartal Kosuyolu High Specialty Education and Research HospitalIstanbulTurkey

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