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The Mount Sinai Hospital

1468 Madison Avenue, New York,
New York 10029

Edge to Edge Mitral Valve Repair with MitraClip

Mitral clip

87 year old male with known history of mitral regurgitation, hypertension, hyperlipidemia, CAD s/p DES PCI to RCA (2010 and 2015), ischemic cardiomyopathy, carotid artery stenosis, and frailty presents with worsening dyspnea on exertion NYHA Class III for 6 months. A transthoracic echocardiogram showed LVEF 30%, moderately dilated LV (LVIDs 4.8 cm, LVIDd 6.3 cm) with severe global hypokinesis, mildly dilated LA, and severe mitral regurgitation. A subsequent transesophageal echocardiogram (TEE) revealed a moderately dilated LV with annular dilation, partial prolapse of the posterior mitral valve leaflet with severe centrally-directed mitral regurgitation involving the A2/P2 segment and no mitral stenosis. The STS mortality risk for surgical MVR is 4.1% and the logistic Euroscore mortality risk is 13.1%. The patient underwent a Heart Team evaluation and was found to be prohibitive risk for surgical MVR due to comorbidities, advanced age and frailty. Patient is now planned for edge-to-edge mitral valve repair with MitraClip via a transfemoral venous access and transseptal puncture.


Case presentation


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