Pushing with the pigtail: a novel approach to placing the MitraClip in a patient with a severely restricted posterior mitral leaflet

Catheter Cardiovasc Interv. 2015 Apr;85(5):906-8. doi: 10.1002/ccd.25634. Epub 2014 Aug 22.

Abstract

The MitraClip is an US Food and Drug Administration-approved device for inoperable patients with severe degenerative mitral regurgitation (MR) and is under investigation for use in patients with severe functional MR. Simultaneously grasping both leaflets of the mitral valve can be technically challenging, however, in patients with a restricted posterior leaflet. We present one such case in which a pigtail catheter, placed retrograde into the left ventricle, was able to push the ventricular surface of the posterior leaflet into closer approximation with the anterior leaflet, and facilitate successful clip placement. We provide this report in hopes that it will provide a useful strategy for interventionalists faced with this challenging situation.

Keywords: mitral valve insufficiency; mitral valve interventions; structural heart disease interventions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Catheterization*
  • Echocardiography
  • Equipment Design
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Humans
  • Male
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / surgery*
  • Severity of Illness Index