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Review
. 2019 Oct 18:6:146.
doi: 10.3389/fcvm.2019.00146. eCollection 2019.

Complications Following Percutaneous Mitral Valve Repair

Livia Gheorghe  1 , Alfonso Ielasi  2 , Benno J W M Rensing  1 , Frank D Eefting  1 , Leo Timmers  1 , Azeem Latib  3 , Martin J Swaans  1
Affiliations
Review

Complications Following Percutaneous Mitral Valve Repair

Livia Gheorghe et al. Front Cardiovasc Med. .

Abstract

Mitral valve disease affects more than 4 million people in the United States and it is the second most prevalent valvulopathy in Europe. The gold standard of treatment in these patients is surgical repair or mitral valve replacement. In the last decade, numerous transcatheter therapies have been developed to overcome the increased number of subjects with symptomatic severe mitral regurgitation and high surgical risk. The Mitraclip (Abbott Vascular, Menlo Park, CA), PASCAL (Edwards Lifesciences, Irvine, CA, USA), the Carillon™ Mitral Contour System™ (Cardiac Dimension Inc., Kirkland, WA, USA), the Mitralign™ (Mitralign, Tewksbury, Massachusetts), and the Cardioband (Edwards Lifesciences, Irvine, CA) are the principal percutaneous devices for mitral valve repair. We present an evidence-based clinical update that provides an overview of these technologies and their potential complications.

Keywords: Cardioband; Carillon device; MitraClip®; Mitralign; complications; mitral valve (MV) repair; transcatheter interventions.

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Figures

Figure 1
Figure 1
Vascular access complications. (A) Major vascular access complication with small laceration of the femoral artery with important fibrotic (adhesions) tissue (yellow arrow). (B) Sheath's kinking which does not allow the advance of the transeptal puncture catheter (yellow circle), due to important adhesions between the femoral artery and vein with severe calcified and tortuous iliac artery.
Figure 2
Figure 2
Late Mitraclip embolization. (Left) Clip embolization into the axillary artery Courtesy Dr. Bilge. (Right) Clip embolization into the femoral artery.
Figure 3
Figure 3
Pericardial effusion (arrow) and cardiac tamponade following the Carillon device delivery system advancement outside the coronary sinus.
Figure 4
Figure 4
Uncontrolled hydrophilic wire advancement (A) leading to coronary sinus perforation (B).
Figure 5
Figure 5
First obtuse marginal narrowing associated with the slow flow (A) following implantation and release of the first Cardioband anchor managed with non-compliant balloon inflation (B) with narrowing resolution and flow restoration (C).
Figure 6
Figure 6
Flow reduction on distal left circumflex (A) after the third anchor placement managed by balloon inflation (B) which caused anchor detachment with residual coronary-left atrial fistula (C, arrow) managed conservatively (covered stent did not advance through the left main toward the left circumflex) with the resolution at 1 month.
Figure 7
Figure 7
(A,B) Guidewire rupture and implant contraction failure with loose of the cinching initially acquired.
See this image and copyright information in PMC

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