Baylor University Medical Center Proceedings April 2017 - 226

Use of a MitraClip for severe mitral regurgitation in a cardiac
transplant patient
Fayez S. Raza, MD, Paul A. Grayburn, MD, and James W. Choi, MD

Severe mitral regurgitation (MR) in patients after cardiac transplant has not
been well studied. Traditionally, patients
have undergone corrective surgery. We
report a 64-year-old man who presented
with new heart failure symptoms 6 months
after cardiac transplantation. He was
found to have severe MR and underwent
successful implantation of a MitraClip®
with reduction of his MR to mild as well as
improvement in his symptoms. Six months
later he was still doing well, and a repeat
echocardiogram showed good results. We
found two previously reported cases using
the MitraClip to treat severe MR in adult
cardiac transplant patients. The MitraClip
is a viable treatment option for MR in
cardiac transplant patients despite their
distorted anatomy.

a

b

c

d

I

n nontransplant patients at prohibitive surgical risk, the MitraClip ® (Abbot Vascular, Santa
Clara, CA) provides a therapeutic treatment option for mitral regurgitation (MR). The MitraClip is
a Food and Drug Administration-
Figure 1. Preprocedure transesophageal echocardiogram demonstrating severe mitral valve regurgitation.
approved percutaneous mitral valve
repair system for severe degenerative MR. Current trials are
sternotomy. It has not been well studied how best to treat these
evaluating its role in functional regurgitation. The system utihigh-risk patients and whether the MitraClip is a feasible and
lizes a cobalt-chromium clip covered with a polypropylene
safe option in this population.
fabric to grasp the mitral leaflets, thus reducing regurgitation
by increasing leaflet coaptation. Insertion of the MitraClip
CASE PRESENTATION
is a challenging procedure and must be performed by a wellA 64-year-old man with idiopathic dilated cardiomyopatrained team under fluoroscopic and echocardiographic
thy underwent cardiac transplantation for end-stage heart
guidance.
Traditionally, severe mitral valve disease after transplantation
From Baylor Heart and Vascular Hospital, Dallas, Texas.
has been addressed by a surgical approach (1-3). Unfortunately,
Corresponding author: James W. Choi, MD, Cardiology Consultants of Texas,
many patients may be at high surgical risk for complications
621 North Hall Street, Suite 400, Dallas, TX 75226 (e-mail: James.Choi@
BSWHealth.org).
due to comorbidities, functional status, and need for repeat
226

Proc (Bayl Univ Med Cent) 2017;30(2):226-227



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