Management of Mitral Clip Detachment in an Elective Mitral Valve Clipping

According to the American College of Cardiology, more than 42,000 patients undergo mitral valve surgery in the United States per year. The treatment of mitral valve regurgitation can be extremely complex and has been delegated almost exclusively to cardiothoracic surgeons. In recent years, the creation of a commercial available percutaneous mitral clipping device called the MitraClipTM (Abbott Global Healthcare), that anchors one edge of the mitral valve leaflet to its corresponding opposite leaflet, has gained favor among cardiothoracic surgeons and cardiologists for patients who would be at high risk for morbidity and mortality with open cardiac surgery. In the recent EVEREST II 5-year follow up study, Feldman et al. [1] reported that both percutaneous mitral clipping and surgical intervention have similar long term results in MR reduction. We report a case of a deployed mitral clip detaching from the posterior leaflet, while remaining attached to a flail segment of the anterior leaflet. Another percutaneous mitral clip was placed alongside the failed mitral clip, resulting in a clinically significant reduction in MR.