Emergent valve replacement after circular mapping catheter entrapment in mitral valve apparatus

Interact Cardiovasc Thorac Surg. 2021 Jun 28;33(1):136-138. doi: 10.1093/icvts/ivab042.

Abstract

We present the case of a 47-year-old male patient with a history of symptomatic paroxysmal atrial fibrillation who failed guideline-directed medical treatment and cardioversion. Electrical mapping was attempted and complicated with catheter entrapping in the mitral valve (MV) apparatus, and multiple attempts for retrieval were unsuccessful and caused severe valvular dysfunction. Emergent valve replacement was required secondary to the extensive disruption of the valvular apparatus and posterior annulus. Mapping catheter entrapment in the valvular apparatus is an uncommon complication, but when it occurs, there is a high risk of injury to the MV apparatus during retrieval. To avoid extensive MV damage, operators should use minimal force during standard manoeuvres to extract the catheter. If gentle retrieval manoeuvres fail, surgical exploration and open retrieval may prevent MV damage. Early surgical consultation and exploration could result in open catheter retrieval or MV repair versus MV replacement.

Keywords: Cardiac surgery; Catheter entrapment; Mitral valve; Valve dysfunction.

Publication types

  • Case Reports

MeSH terms

  • Atrial Fibrillation* / surgery
  • Atrial Fibrillation* / therapy
  • Catheter Ablation*
  • Catheters
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency* / diagnostic imaging
  • Mitral Valve Insufficiency* / etiology
  • Mitral Valve Insufficiency* / surgery
  • Treatment Outcome