85 year old male presented with progressive dyspnea on exertion (NYHA Class III). Past medial history was significant for MI, CAD with CABG, AF, CKD and Asthma. TTE revealed severe mitral regurgitation with preserved LV function. Coronary angiogram showed native III V CAD and patent grafts. TEE confirmed severe mitral regurgitation (Carpentier type III) with restricted motion of posterior leaflet and two jets located between A2/P2 scallops. The STS mortality risk for Surgical MVR was 17.82 % and the Logistic Euroscore mortality risk was 58.93%. Patient was determined to be at extreme risk for surgical MVR due to co-morbidities. Pt is now planned for mitral valve edge-to-edge repair with MitraClip.
Do u think the clip was postioned too laterally on A2 P2. The greater MR was medial to A2P2
Dr Sharma, Dr Kini and the team are excellent. They save lives daily.