Abstract
This case describes a patient who had been treated with the MitraClip for severe degenerative mitral regurgitation. He then developed infective endocarditis of the mitral valve associated with the MitraClip more than a year after the index procedure. This was complicated by systemic embolization from the endocarditis
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Trans-thoracic apical four-chamber view zoomed on the mitral valve. The clip is seen and is associated with a highly mobile mass suggestive of a vegetation. The mass appears to pass in and out of view in a posterior direction (MP4 1363 kb)
Trans-thoracic apical two-chamber view. The MitraClip is seen and is associated with a highly mobile mass suggestive of a vegetation. The mass appears to pass in and out of view (MP4 1426 kb)
Trans-thoracic parasternal long axis view. The clip is seen and is associated with a highly mobile mass (arrows) suggestive of a vegetation. The mass appears to pass in and out of view in a posterior direction (MP4 989 kb)
Zooms in on the mitral valve, clip, and the mass seen in Video 20.3 (arrows) (MP4 1488 kb)
Trans-thoracic parasternal long axis view. The clip is seen and is associated with at least moderate degree of mitral regurgitation with a posteriorly directed jet (MP4 952 kb)
Trans-thoracic parasternal short axis view at the mitral valve level. The clip is seen at central aspect of the mitral valve and is associated with a highly mobile mass suggestive of a vegetation (arrows). The mass appears to flick in and out of view in a posterior direction (MP4 976 kb)
Zooms in on the mitral valve and the mass seen in Video 20.6 (MP4 1036 kb)
Trans-thoracic apical four-chamber view zoomed on the mitral valve. The clip is seen and is associated with a highly mobile mass suggestive of a vegetation (arrows) (MP4 1049 kb)
Trans-thoracic parasternal long axis view. The clip is seen, but the large mass is no longer present (MP4 1258 kb)
Trans-thoracic parasternal short axis view at the mitral valve level. The clip is seen, but the large mass seen in previous figures is not present, suggesting possible embolization. On close inspection, a small mobile mass is visible in association with the MitraClip on the posterior leaflet of the mitral valve (arrows) (MP4 1307 kb)
Trans-thoracic apical four-chamber view zoomed on the mitral valve. The clip is seen and is associated with a small mobile mass as oppose to a large mass seen on the previous figures (MP4 1269 kb)
Transesophageal modified bi-commissural view at 45° showing MitraClip at A2/P2 position. There is a small mobile mass (arrow) associated with the clip on the atrial surface (MP4 4089 kb)
Transesophageal modified bi-commissural view at 45° zoomed in on the mitral valve and showing the MitraClip at A2/P2 position. There is a small mobile mass (solid arrow) and two larger calcified mobile masses (broken arrow) associated with the clip on the atrial surface of the clip and mitral valve (MP4 4067 kb)
Transesophageal modified bi-commissural view at 36° showing MitraClip at A2/P2 position. There is a small mobile mass (arrow) and larger calcified mobile mass associated with the clip on the atrial surface of the mitral valve (MP4 1305 kb)
Transesophageal modified bi-commissural view at 29° zoomed in on the mitral valve showing the MitraClip positioned A2/P2 associated with two large (broken arrows) mobile calcified masses (MP4 1341 kb)
Transesophageal modified bi-commissural view at 76° zoomed in on the mitral valve showing MitraClip at A2/P2 position. There is a small mobile mass (arrow) and a larger mobile calcified mobile mass associated with the clip on the atrial surface of the clip and the mitral valve (MP4 1407 kb)
Transesophageal two-chamber view at 90° showing MitraClip at A2/P2 position, with a degree of prolapse of the anterior leaflet resulting in at least moderate regurgitant jet passing posteriorly and hugging the posterior aspect of the atrial wall (MP4 1476 kb)
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Vazir, A., Franzen, O., Moat, N.E., Price, S. (2013). Infective Endocarditis Associated with the MitraClip. In: Feldman, T., Franzen, O., Low, R., Rogers, J., Yeo, K.K. (eds) Atlas of Percutaneous Edge-to-Edge Mitral Valve Repair. Springer, London. https://doi.org/10.1007/978-1-4471-4294-2_20
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DOI: https://doi.org/10.1007/978-1-4471-4294-2_20
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Publisher Name: Springer, London
Print ISBN: 978-1-4471-4293-5
Online ISBN: 978-1-4471-4294-2
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