Key result
MitraClip via the right internal jugular approach was successfully performed, providing a viable alternative to perform the procedure when femoral access is contraindicated or prohibitive.
Why the study?
Transfemoral MitraClip delivery is not technically feasible in some patients, and alternate routes present amplified technical considerations and challenges.
Is the right internal jugular approach a feasible alternative for the MitraClip procedure in patients with contraindicated or prohibitive femoral access?
Case Report (n=1)
Is the right internal jugular approach a feasible alternative for the MitraClip procedure in patients with contraindicated or prohibitive femoral access?
The transjugular approach is a technically feasible alternative for MitraClip implantation when standard transfemoral access is contraindicated.
May offer an alternative in prohibitive femoral access; leaves open safety and efficacy in larger cohorts.
The MitraClip procedure is carried out almost exclusively via the transfemoral approach. However, in some patients transfemoral delivery of MitraClip is not technically feasible (e.g., occluded inferior vena cava or tortuous/obstructive iliofemoral venous anatomy). The technical considerations and challenges of the MitraClip procedure are amplified when an alternate route is considered. We describe a successful case of MitraClip performed via the right internal jugular (IJ) approach in a patient with a flail A3 scallop and previous mitral valve repair. We reviewed prior cases in the literature and discuss step-by-step the pertinent clinical and technical considerations for performing this procedure via the transjugular route. In summary, the right IJ access site provides a reasonable alternative to perform the MitraClip procedure in cases where femoral access is contraindicated or prohibitive. A thorough understanding of the technical considerations is crucial in improving procedural success rates.
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Yap et al. (2020) conducted a case report in Flail A3 scallop and previous mitral valve repair (n=1). MitraClip via right internal jugular approach was evaluated. MitraClip via the right internal jugular approach was successfully performed, providing a viable alternative to perform the procedure when femoral access is contraindicated or prohibitive.
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