Key result
MitraClip implantation via the right upper pulmonary vein through a right mini-thoracotomy successfully reduced mitral insufficiency in a patient with agenesis of the inferior vena cava.
Why the study?
Is MitraClip implantation via pulmonary vein access feasible in a patient with severe mitral regurgitation and agenesis of the inferior vena cava?
Case Report (n=1)
Is MitraClip implantation via pulmonary vein access feasible in a patient with severe mitral regurgitation and agenesis of the inferior vena cava?
MitraClip implantation via the right upper pulmonary vein is a feasible alternative access route for patients with severe mitral regurgitation and absent or occluded inferior vena cava.
May enable alternative MitraClip access in IVC agenesis; leaves open need for prospective safety data.
AIMS: Transcatheter mitral valve repair has become a promising alternative treatment option for severe symptomatic mitral regurgitation in patients at high risk for open heart surgery with heart-lung bypass. METHODS AND RESULTS: We describe the first successful procedure of mitral clipping through a right lateral mini-thoracotomy via the right upper pulmonary vein in a patient with an agenesis of the inferior vena cava. The set-up of the MitraClip system on a separate table located at 70¡ on the right side of the patient and the fixation of the steerable sheath at the entry into the thorax with constant posterior pressure enabled clip implantation using the usual manoeuvres with marked reduction of the mitral insufficiency. CONCLUSIONS: The access through the right upper pulmonary vein using the usual right mini-thoracotomy enabled a successful mitral clipping even in the absence or occlusion of the inferior vena cava.
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Tiroch et al. (2015) conducted a case report in Severe symptomatic mitral regurgitation with agenesis of the inferior vena cava (n=1). MitraClip via pulmonary vein access through a right mini-thoracotomy was evaluated on Successful mitral clipping with marked reduction of mitral insufficiency. MitraClip implantation via the right upper pulmonary vein through a right mini-thoracotomy successfully reduced mitral insufficiency in a patient with agenesis of the inferior vena cava.