An 83-year-old man presented with symptomatic, recurrent severe mitral regurgitation (MR) two years after a previous transcatheter mitral valve repair with MitraClip (Abbott Structural, Menlo Park, CA), in which closure of a large iatrogenic atrial septal defect (iASD) with an 28-mm Amplatzer atrial septal occluder (ASO) was performed. Following a multidisciplinary heart team evaluation, a second MitraClip procedure was undertaken.Initial procedural imaging demonstrated no space posterior to the ASO for a safe transseptal puncture, necessitating crossing of the ASO for the placement of the 24-French steerable guide catheter (SGC) to enable the second MitraClip procedure.
2. Valve Science Center at the Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States.
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