title: Conventional Surgery for Early and Late Symptomatic Mitral Valve Stenosis After MitraClip®Intervention: An Institutional Experience With Four Consecutive Patients.
abstract: BACKGROUND
  Surgical mitral valve repair is the gold standard for treatment of mitral regurgitation. Recently, the transcatheter treatment of mitral regurgitation with the MitraClip®device (Abbot Vascular Structural Heart, Menlo Park, CA) has demonstrated promising results in treating patients not amenable for surgical correction of mitral valve regurgitation. Most patients reported in the literature requiring surgical bailout after MitraClip treatment presented with residual or recurrent mitral valve regurgitation. Mitral valve stenosis after MitraClip treatment has been rarely reported.
  
  
  METHODS
  From February 2010 to December 2014, four patients out of 165 patients who underwent MitraClip therapy developed symptomatic mitral valve stenosis (2.4%) and needed surgical correction. Data of the four patients were reviewed retrospectively. Follow-up data were obtained from each patient's general practitioner/cardiologist by phone calls and facsimile and were complete in all patients.
  
  
  RESULTS
  All four patients were treated with ≥ 2 MitraClip (MC) devices during their initial presentation. All four patients underwent MV replacement with a tissue valve. The postoperative course was uneventful and there was no 30-day mortality. At 6-month follow-up, all patients were alive and in NYHA class I-III.
  
  
  CONCLUSIONS
  Placement of multiple clip devices may lead to slightly elevated transmitral gradients. This may not necessarily interpret into symptomatic mitral stenosis. However, in some cases this is possible. Caution should be exercised at this phase of the learning curve of the percutaneous MC treatment, especially in use of multiple MC devices.
authors.affiliation: Department of Cardiac Surgery, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany.
authors.forename: Anthony
authors.initials: A
authors.lastname: Alozie
authors.affiliation: Department of Cardiology, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany.
authors.forename: Liliya
authors.initials: L
authors.lastname: Paranskaya
authors.affiliation: Department of Cardiac Surgery, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Westphal
authors.affiliation: Department of Cardiac Surgery, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kaminski
authors.affiliation: Department of Cardiac Surgery, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany.
authors.forename: Gustav
authors.initials: G
authors.lastname: Steinhoff
authors.affiliation: Department of Cardiology, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sherif
authors.affiliation: Department of Cardiology, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ince
authors.affiliation: Department of Cardiology, Heart Center Rostock, University Medical Center Rostock, Rostock, Germany. Electronic address: alper.oener@med.uni-rostock.de.
authors.forename: Alper
authors.initials: A
authors.lastname: Öner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058385:Cardiac Valve Annuloplasty / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors
keywords: MitraClip(®); Mitral valve repair; Mitral valve replacement; Mitral valve stenosis