Thinking about the case...

MitraClip procedure for the treatment of a pseudo-cleft in the posterior mitral leaflet

This research article explores a rare mitral valve anatomical condition involving a pseudo-cleft in the posterior leaflet, demonstrating how 3D echocardiography can effectively clarify pathoanatomy and guide MitraClip intervention in high-risk patients with asymmetric left ventricular dilatation. The authors emphasize that such complex mitral valve procedures should be performed exclusively in experienced high-volume cardiac centers.

Link to Öztürk et al. EHJ Cardiovascular Imaging (Full text available free)

Extract

This case depicts a rare anatomical condition: an MV pseudo-cleft caused by severe tension on the posterior leaflet tip due to asymmetric left ventricular dilatation. 3D echocardiography was of great value to clarify the underlying pathoanatomy and to exclude prohibitive anatomical condition. Therefore, MitraClip implantation was a valuable treatment option in this high-risk patient. However, the MitraClip procedure should not be regarded as first-line treatment in patients with supposedly adverse anatomy; such procedures should be performed in experienced high-volume centres.