The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Transcatheter Therapy for Residual MR and Iatrogenic ASD after MitraClip and ASD closure

DOI: 10.4244/EIJ-D-19-01064

1. Valve Science centre at the Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States, United States
2. Valve Science Center at the Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States.
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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. 

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