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Severe infective endocarditis after MitraClip implantation treated by cardiac surgery

Christian Frerker1, Karl-Heinz Kuck, Tobias Schmidt

  • 1Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|August 20, 2014
PubMed
Abstract

Insights

This case report details the first instance of infective endocarditis (IE) following a MitraClip procedure. Surgical intervention for recurrent mitral regurgitation (MR) due to IE proved successful, even in high-risk patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • MitraClip® is a device used to treat mitral regurgitation (MR).
  • Infective endocarditis (IE) is a rare but serious complication following cardiac procedures.
  • High surgical risk patients often benefit from less invasive procedures like MitraClip®.

Observation:

  • An 88-year-old patient with severe MR underwent MitraClip® implantation.
  • One month post-procedure, the patient presented with fever and dyspnea, indicating recurrent MR and suspected IE.
  • Echocardiography revealed vegetation and ulceration in the clip region, with positive blood cultures for Staphylococcus aureus.

Findings:

  • The patient underwent successful mitral valve replacement due to IE, despite a high logistic EuroSCORE.
  • Histological analysis confirmed active IE on the clip devices.
  • Post-surgery, the patient showed no mitral regurgitation and a favorable mitral valve bioprosthesis gradient.

Implications:

  • Mitral valve replacement can be a viable bail-out strategy for IE after MitraClip®.
  • Successful surgical outcomes are achievable even in extremely high-risk patients.
  • This case highlights the importance of vigilance for IE post-MitraClip® procedures.

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