Key result
Transcatheter mitral valve repair using the MitraClip device can cause systolic anterior motion and left ventricular outflow tract obstruction, which resolved after pericardial drainage.
Why the study?
Can systolic anterior motion (SAM) and left ventricular outflow tract obstruction (LVOTO) occur after transcatheter mitral valve repair (TMVR) using the MitraClip device?
Case Report (n=1)
Can systolic anterior motion (SAM) and left ventricular outflow tract obstruction (LVOTO) occur after transcatheter mitral valve repair (TMVR) using the MitraClip device?
Systolic anterior motion and left ventricular outflow tract obstruction can occur after MitraClip implantation, and addressing reversible aggravators like pericardial effusion is essential for clinical resolution.
Systolic anterior motion (SAM) of the anterior mitral leaflet is a well reported complication of surgical mitral valve repair (MVR). In the current report, we present a case of SAM with left ventricular outflow tract obstruction (LVOTO) which occurred after transcatheter mitral valve repair (TMVR) using the MitraClip device. LVOTO was caused by the combination of protrusion of the MitraClip device into the LVOT and underfilling of the left ventricle due to pericardial effusion and atrial fibrillation. Rapid clinical resolution and marked decline in LVOT pressure gradient occurred following surgical drainage and windowing of the pericardium. We conclude that SAM and LVOTO could occur after TMVR. Seeking and addressing reversible aggravators of LVOTO including pericardial effusion is essential and could potentially make the difference between a successful procedure and a failed one.
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Levi et al. (2016) conducted a case report in Systolic anterior motion with left ventricular outflow tract obstruction (n=1). Transcatheter mitral valve repair (MitraClip) was evaluated. Transcatheter mitral valve repair using the MitraClip device can cause systolic anterior motion and left ventricular outflow tract obstruction, which resolved after pericardial drainage.
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