Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Aug 13;23(9):131.
doi: 10.1007/s11886-021-01553-9.

Complications Following MitraClip Implantation

Katharina Schnitzler #  1 , Michaela Hell #  1 , Martin Geyer  1 , Felix Kreidel  1 , Thomas Münzel  1 , Ralph Stephan von Bardeleben  2
Affiliations
Review

Complications Following MitraClip Implantation

Katharina Schnitzler et al. Curr Cardiol Rep. .

Abstract

Purpose of review: To provide a detailed overview of complications associated with MitraClip therapy and its development over time with the aim to alert physicians for early recognition of complications and to offer treatment strategies for each complication, if possible.

Recent findings: The MitraClip system (MC) is the leading transcatheter technique to treat mitral regurgitation (MR) and has been established as a safe procedure with very low adverse event rates compared to mitral surgery at intermediate to high risk or in secondary MR. Lately, the fourth MC generation has been launched with novel technical features to facilitate device handling, decrease complication rates, and allow the treatment of even complex lesions. Although the complication rate is low, adverse events are associated with increased morbidity and mortality. The most common complications are bleeding, acute kidney failure, procedure-induced mitral stenosis, and an iatrogenic atrial septal defect with unknown clinical impact.

Keywords: Complications; MitraClip; Mitral regurgitation; Transcatheter edge-to-edge repair (TEER); Transcatheter mitral valve repair (TMVR).

PubMed Disclaimer

Conflict of interest statement

Felix Kreidel reports having received speaker’s honoraria from Abbott Cardiovascular and Edwards Lifesciences, outside the submitted work.

Ralph Stephan von Bardeleben reports advisory board activity outside the submitted paper from Abbott, Bioventrix, Boston Scientific, Edwards Lifesciences, and Medtronic and trial steering committee and lecture honoraria from Abbott Cardiovascular and Edwards Lifesciences.

The other authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Evolution of MitraClip. This figure demonstrates the four MitraClip generations. (MitraClip TM is a trademark of Abbott or its related companies. Reproduced with permission of Abbott, © 2021. All rights reserved)
Fig. 2
Fig. 2
Complications following MitraClip implantation. iASD, iatrogenic atrial septal defect; SLDA, single leaflet device attachment
Fig. 3
Fig. 3
Perforation. Presentation of an intraprocedural leaflet perforation during grasping. A Transesophageal commissural view demonstrating the grasp of the leaflet showing the posterior leaflet (arrow) still on the clip (*). B Transesophageal commissural view showing the perforated posterior leaflet (arrow). *MitraClip
See this image and copyright information in PMC

References

    1. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368(9540):1005–1011. doi: 10.1016/S0140-6736(06)69208-8. - DOI - PubMed
    1. Coffey S, Cairns BJ, Iung B. The modern epidemiology of heart valve disease. Heart. 102(1):75–85. - PubMed
    1. Goel SS, Bajaj N, Aggarwal B, Gupta S, Poddar KL, Ige M, et al. Prevalence and outcomes of unoperated patients with severe symptomatic mitral regurgitation and heart failure: comprehensive analysis to determine the potential role of MitraClip for this unmet need. J Am Coll Cardiol. 63(2):185–6. - PubMed
    1. Feldman T, Kar S, Elmariah S, Smart SC, Trento A, Siegel RJ, Apruzzese P, Fail P, Rinaldi MJ, Smalling RW, Hermiller JB, Heimansohn D, Gray WA, Grayburn PA, Mack MJ, Lim DS, Ailawadi G, Herrmann HC, Acker MA, Silvestry FE, Foster E, Wang A, Glower DD, Mauri L, EVEREST II Investigators Randomized comparison of percutaneous repair and surgery for mitral regurgitation: 5-year results of EVEREST II. J Am Coll Cardiol. 2015;66(25):2844–2854. doi: 10.1016/j.jacc.2015.10.018. - DOI - PubMed
    1. Maisano F, Franzen O, Baldus S, Schäfer U, Hausleiter J, Butter C, Ussia GP, Sievert H, Richardt G, Widder JD, Moccetti T, Schillinger W. Percutaneous mitral valve interventions in the real world: early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol. 2013;62(12):1052–1061. doi: 10.1016/j.jacc.2013.02.094. - DOI - PubMed

Publication types

MeSH terms