An 84-year-old woman, presenting with dyspnoea (New York Heart Association class III) and edema, underwent an edge-to-edge mitral valve repair with the MitraClip XTR system (Abbott, Santa Clara, USA) for the treatment of severe functional mitral regurgitation (MR) (Online video S1). After grasping the leaflets and closing the MitraClip, intraprocedural transesophageal echocardiography detected a new substantial regurgitation through an iatrogenic laceration in the anterior leaflet that was believed to be caused by tension stress on the XTR device (Figure 1A-B; Online video S2-3). Because the device’s arms could not reach far enough to cover the laceration in the several attempts that were made, the MitraClip was not implanted and the system was extracted.
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