What question did this study set out to answer?

To evaluate whether transcatheter electrosurgery can detach previously placed MitraClips from the anterior mitral leaflet to recreate a single mitral orifice for transcatheter mitral valve implantation without disrupting bioprosthetic function.

August 31, 2026JACC: Cardiovascular InterventionsOpen Access

Electrosurgical Detachment of MitraClips From the Anterior Mitral Leaflet Prior to Transcatheter Mitral Valve Implantation

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Severe mitral regurgitation or stenosis after MitraClip implantation (n=5). Intervention: Transcatheter electrosurgical detachment of MitraClip (ELASTA-Clip) followed by TMVI with Tendyne bioprosthesis. Primary outcome: Technical success (MitraClip detachment and Tendyne implantation) and survival to 30 days.

View Full Paper

Ask AI

Bookmark

Key result

Electrosurgical MitraClip detachment before TMVI achieves 100% technical success and 30-day survival.

Why the study?

Patients with severe mitral regurgitation or stenosis after MitraClip repair have few therapeutic options because the resulting double orifice precludes TMVI, prompting evaluation of electrosurgical clip detachment to recreate a single orifice.

Is transcatheter electrosurgical detachment of failed MitraClips followed by TMVI feasible and safe in patients with recurrent severe mitral regurgitation who are ineligible for surgery?

Key Points

To evaluate whether transcatheter electrosurgery can detach previously placed MitraClips from the anterior mitral leaflet to recreate a single mitral orifice for transcatheter mitral valve implantation without disrupting bioprosthetic function.
Retrospective observational cohort study of 5 consecutive patients with severe mitral regurgitation or stenosis following prior edge-to-edge repair at a single center.
Conducted transcatheter electrosurgical laceration to separate failed MitraClips from the anterior leaflet while leaving them secured to the posterior leaflet.
Performed transcatheter mitral valve implantation using the Tendyne mitral bioprosthesis on a compassionate-use basis, with clinical follow-up through 30 days.
Electrosurgical MitraClip detachment and Tendyne valve implantation achieved 100% technical success (5 of 5 patients), with 100% procedural survival and 100% survival to discharge.
All 5 patients (100%) were discharged with grade 0 central mitral regurgitation, though 2 patients had moderate perivalvular regurgitation that did not require reintervention.
Through 30-day follow-up, there were no deaths, valve dysfunctions, reinterventions, or complications related to erosion or embolization of the retained posterior MitraClips.

Study Design

Type

Cohort (n=5)

Multicenter

Structured PICO

Is transcatheter electrosurgical detachment of failed MitraClips followed by TMVI feasible and safe in patients with recurrent severe mitral regurgitation who are ineligible for surgery?

Population

5 older adults (median age 79, 60% female) with severe residual mitral regurgitation after MitraClip implantation, ineligible for surgery, followed for 30 days.

Intervention

Transcatheter electrosurgical detachment of failed MitraClips from the anterior leaflet (ELASTA-Clip) followed by transcatheter mitral valve implantation (TMVI) with the Tendyne mitral bioprosthesis.

Outcome

Technical feasibility and safety at 30 days (survival, valve dysfunction, reintervention).safety

Limitations

Small sample size
Single center
Compassionate-use basis with FDA off-label use
No control group
Small series of patients at a single center
Compassionate-use basis with FDA off-label use, limiting generalizability
No control group or comparator group of patients who underwent surgical mitral valve replacement

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Electrosurgical detachment of failed MitraClips to recreate a single orifice for transcatheter mitral valve implantation is technically feasible and safe at 30 days, offering a novel option for patients with recurrent MR and prohibitive surgical risk.

Cite This Study

Lisko et al. (2020) conducted a cohort in Severe mitral regurgitation or stenosis after MitraClip implantation (n=5). Transcatheter electrosurgical detachment of MitraClip (ELASTA-Clip) followed by TMVI with Tendyne bioprosthesis was evaluated on Technical success (MitraClip detachment and Tendyne implantation) and survival to 30 days. Transcatheter electrosurgical detachment of failed MitraClips from the anterior leaflet followed by TMVI was technically successful and safe in all 5 patients at 30 days.

synapsesocial.com/papers/6a9529e811d0ab94587baeb6 https://doi.org/10.1016/j.jcin.2020.06.047

Topics

Mitral valve intervention

View Full Paper

Ask AI

Bookmark

Electrosurgical Detachment of MitraClips From the Anterior Mitral Leaflet Prior to Transcatheter Mitral Valve Implantation

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Electrosurgical Detachment of MitraClips From the Anterior Mitral Leaflet Prior to Transcatheter Mitral Valve Implantation

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider