Surgical conversion early after failed percutaneous repair with the Mitraclip system

A 72-year-old man underwent mitral valve (MV) replacement after failed percutaneous MV repair with the MitraClip (Abbott Vascular, USA) (Fig. 1). Our report demonstrated that the condition of MV could be deteriorated (Fig. 2), therefore, the chances of a successful surgical MV repair might be reduced after percutaneous MV intervention. A preinterventional transoesophageal echocardiogram demonstrated moderate-to-severe mitral regurgitation due to prolapse of the A2 segment of the anterior mitral leaflet (A). A postinterventional transoesophageal echocardiogram demonstrated residual severe mitral regurgitation and the MitraClip (white arrow) which gripped only the anterior leaflet (B). Operative finding. The leaflets were prolapsed due to rupture of anterior and posterior mitral chordae after percutaneous mitral valve repair with the MitraClip system (A). The MitraClip (black arrow) gripped only the anterior leaflet (B).