title: Pigtail catheter "propping" for MitraClip percutaneous transcatheter mitral valve repair.
abstract: In recent years percutaneous therapy has emerged as a feasible and effective option for the treatment of mitral regurgitation, particularly in cases where the risks of conventional cardiac surgery are prohibitively high. To date the most widely used percutaneous approach is beating heart, edge-to-edge repair with the MitraClip device (Abbott Vascular-Structural Heart, Menlo Park, CA). The technique requires simultaneous grasping and approximation of both mitral valve leaflets prior to securing and releasing the clip. However, this may be technically challenging or indeed impossible in patients with failure of coaptation, particularly when there is a large coaptation gap. We present an approach for overcoming this relatively common obstacle based on "propping" the anterior mitral valve leaflet toward its posterior counterpart with a diagnostic pigtail catheter to reduce the coaptation gap and to allow grasping of both leaflets without difficulty. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Royal Stoke University Hospital, Newcastle Road, Stoke on Trent, ST4 6GQ, United Kingdom.
authors.forename: Kully
authors.initials: K
authors.lastname: Sandhu
authors.affiliation: Royal Stoke University Hospital, Newcastle Road, Stoke on Trent, ST4 6GQ, United Kingdom.
authors.forename: Robert
authors.initials: R
authors.lastname: Butler
authors.affiliation: Royal Stoke University Hospital, Newcastle Road, Stoke on Trent, ST4 6GQ, United Kingdom.
authors.forename: Adrian
authors.initials: A
authors.lastname: Large
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D062906:Cardiac Catheters; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: highlights; mitraclip; mitral valve disease; pigtail propping; transoesophageal echo