09/01/2026
75 Yrs male Presented with Acute decompensated heart failure and pulmonary edema. Echo revealed LAD territory hypokinesia, LVEF-26%, severe MR. severe TR with moderate to severe PAH. Coronary angiography revealed patent stent to LAD, RCA & LCx.
Surgical MVR was not an option because of poor functional class, advanced age, multiple co-morbidities, recurrent heart failure despite optimal medical management, severe MR.
Patient was advised Trans-catheter edge to edge repair TEER (MY CLIP). Trans-septal puncture was done to gain access to the left atrium. The puncture site is carefully selected using TEE guidance to ensure optimal positioning for clip delivery. The Clip Delivery System with the clip attached, was advanced through the guide catheter and positioned above the mitral valve at the site of the regurgitant jet. The clip's orientation was adjusted to be perpendicular to the line of coaptation of the valve leaflets. The leaflets were grasped between the clip arms and grippers under TEE guidance. Once adequate leaflet insertion was confirmed, the clip was partially closed. TEE and left atrial pressure/pulmonary vein flow was used to assess the reduction in MR and ensure there is no significant mitral stenosis. After satisfactory assessment, the clip was fully deployed from the delivery system. Due to residual MR, It was decided to deploy additional clips in parallel with the previous clip. Intra Operative TEE revealed mild MR with no residual MS. Patient tolerated the procedure well. Review 2D Echocardiography revealed LAD territory hypokinesia, LVEF ~ 26%, Mitra clip in situ Mild MR, mild TR with no PAH, No LA/LAA clot. At one month follow-up patient is asymptomatic with good effort tolerance.
TEER (MITRA CLIP/MY CLIP) is good option for transcutaneous repair of secondary severe mitral regurgitation in high surgical risk patient.
