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MitraClip®: Two Weeks after Implantation

Juliëtte F Velu1, Hans H de Boer2, Berto J Bouma1

  • 1Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.

The Journal of Heart Valve Disease
|December 19, 2016
PubMed

Insights

A patient with severe mitral regurgitation (MR) underwent successful MitraClip repair, reducing MR significantly. However, the patient later died from pneumosepsis, with histology revealing inflammation and early tissue coverage on the device.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Severe symptomatic mitral regurgitation (MR) poses significant clinical challenges.
  • Percutaneous mitral valve repair using the MitraClip device offers a less invasive treatment option for MR.
  • Understanding the long-term tissue response to implanted devices is crucial for patient outcomes.

Observation:

  • A 73-year-old male patient with severe MR underwent successful MitraClip repair, reducing MR from grade IV to grade I.
  • The patient experienced a fatal outcome (pneumosepsis) 14 days post-procedure.
  • Histological examination of the MitraClip mesh revealed a chronic inflammatory reaction with multinucleated giant cells.

Findings:

  • The MitraClip device demonstrated effectiveness in reducing mitral regurgitation.
  • Histology showed a significant foreign body reaction, characterized by multinucleated giant cells.
  • Early signs of tissue coverage (myofibroblast presence) on the MitraClip mesh were observed.

Implications:

  • While MitraClip effectively treats MR, potential inflammatory responses and early tissue coverage warrant further investigation.
  • The findings highlight the importance of monitoring for complications such as infection post-procedure.
  • Further research is needed to understand the long-term biological interactions between the MitraClip device and cardiac tissue.

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