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Type: Case Report
Title: Mitral p2 perforation during mitraclip grasping manoeuver, intraprocedural detectation
Authors: Maria-Cruz Ferrer-Gracia
Affiliations: Hemodynamic and Interventional Cardiology Unit, Cardiology Institution, Miguel Servet University Hospital, Zaragoza, Spain.
Abstract: We present a leaflet perforation in an old woman after the first attempt of grasping manoeuvre. During final echocardiographic verifications, just before the releasing of the clip, her mitral regurgitation was worsened. Therefore, we decided to invert the clip and return to the left atrium. After an exhaustive scanning, we observed a new jet inside one leaflet (P2) of the mitral valve. For fear that a new grasping would cause a new jet, a surgical approach was decided to be performed.Intraoperatory images confirmed the tear in the middle of P2. A mechanical mitral prosthesis was successfully implanted and the patient nicely recovered. Mitral leaflet disruption is a rare but serious complication of Mitraclip insertion. In previous reported cases, this condition was observed just in patients who required a surgical approach after clip implantation. Never before has it been described during grasping manoeuvres without liberation of the clip.