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MitraClip in a Patient with Dextrocardia and Scoliosis Complicated by Delayed Clip Detachment

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Abstract

A patient with dextrocardia, scoliosis, restrictive lung disease, severe degenerative mitral regurgitation (MR), and with NYHA Class III heart failure was referred for the MitraClip after unsuccessful surgery. The procedure was complicated by difficult visualization of cardiac anatomy requiring adjunctive imaging with intracardiac echo. Although there was successful leaflet grasp with reduction of MR, the patient deteriorated a few days later with complete clip detachment and return of severe MR.

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Authors and Affiliations

  1. Seldinger Unit, Heart Centre, University Hospital, Linköping, Sweden

    Niels Erik Nielsen M.D., Ph.D., Jacek Baranowski M.D., Ph.D., Gabriella Boano M.D., Eva Nylander M.D., Ph.D. & Lars Wallby M.D., Ph.D.

  2. Department of Cardiology, Heart Centre, University Hospital, Linköping, 58185, Sweden

    Niels Erik Nielsen M.D., Ph.D. & Lars Wallby M.D., Ph.D.

  3. Department of Clinical Physiology, Heart Centre, University Hospital, Linköping, 58185, Sweden

    Jacek Baranowski M.D., Ph.D.

  4. Department of Thoracic Surgery, Heart Centre, University Hospital, Linköping, S-58185, Sweden

    Gabriella Boano M.D.

  5. Department of Clinical Physiology, Faculty of Health Sciences, Heart Centre, University Hospital, Linköping, 58185, Sweden

    Eva Nylander M.D., Ph.D.

Authors
  1. Niels Erik Nielsen M.D., Ph.D.
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  2. Jacek Baranowski M.D., Ph.D.
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  3. Gabriella Boano M.D.
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  4. Eva Nylander M.D., Ph.D.
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  5. Lars Wallby M.D., Ph.D.
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Corresponding author

Correspondence to Niels Erik Nielsen M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Cardiology Division, Evanston Hospital, Illinois, USA

    Ted Feldman M.D., FESC, FACC, FSCAI

  2. Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark

    Olaf Franzen M.D

  3. Royal Brompton Hospital Royal Brompton and Harefield NHS Foundation Trust, London, UK

    Olaf Franzen M.D

  4. Department of Cardiovascular Medicine, University of California Davis Medical Center, Sacramento, CA, USA

    Reginald Low M.D., FACC , Jason Rogers M.D., FACC, FSCAI  & Khung Keong Yeo M.B.B.S., FACC, FSCAI ,  & 

  5. Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore

    Khung Keong Yeo M.B.B.S., FACC, FSCAI

Electronic supplementary material

Below is the link to the electronic supplementary material.

(a) Transesophageal echo view of the transseptal puncture (MP4 1085 kb)

(b) Intracardiac echo view of the transseptal puncture (MP4 3170 kb)

(a) Mitral regurgitation before one MitraClip (MP4 419 kb)

(b) Mitral regurgitation after one MitraClip (MP4 430 kb)

Increased mobility of the MitraClip on post-procedure day 1 (MP4 834 kb)

(a) The clip is no longer attached to the mitral valve (MP4 994 kb)

(b) There is severe prolapse with severe MR on post-procedure day 3 (MP4 305 kb)

Residual MR after the first clip in the redo procedure (MP4 270 kb)

Second MitraClip implanted (MP4 492 kb)

(a) The second MitraClip had partially detached again with severe MR (MP4 258 kb)

(b) Transgastric view showing the mobile clip (MP4 1052 kb)

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© 2013 Springer-Verlag London

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Nielsen, N.E., Baranowski, J., Boano, G., Nylander, E., Wallby, L. (2013). MitraClip in a Patient with Dextrocardia and Scoliosis Complicated by Delayed Clip Detachment. 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_39

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  • DOI: https://doi.org/10.1007/978-1-4471-4294-2_39

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4293-5

  • Online ISBN: 978-1-4471-4294-2

  • eBook Packages: MedicineMedicine (R0)

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