MitraClip-induced systolic anterior motion complicated by pericardial effusion: A case report

Catheter Cardiovasc Interv. 2018 Jun;91(7):1371-1374. doi: 10.1002/ccd.26476. Epub 2016 Mar 4.

Abstract

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. © 2016 Wiley Periodicals, Inc.

Keywords: complications; mitral clip; percutaneous mitral valve repair.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / physiopathology
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Cardiac Catheterization / methods
  • Echocardiography, Doppler, Color
  • Echocardiography, Transesophageal
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis Implantation / methods
  • Heart Valve Prosthesis*
  • Hemodynamics
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / physiopathology
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Pericardial Effusion / complications*
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / physiopathology
  • Pericardial Effusion / therapy
  • Prosthesis Design
  • Recovery of Function
  • Severity of Illness Index
  • Systole
  • Treatment Outcome
  • Ventricular Outflow Obstruction / diagnostic imaging
  • Ventricular Outflow Obstruction / etiology*
  • Ventricular Outflow Obstruction / physiopathology
  • Ventricular Outflow Obstruction / therapy