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Initial Results of Combined MitraClip® Implantation and Left Atrial Appendage Occlusion
Xavier Freixa1, Rodrigo Estévez-Loureiro2, Fernando Carrasco-Chinchilla3
1Department of Cardiology, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain. Electronic correspondence: xavierfreixa@hotmail.com.
Insights
Percutaneous mitral valve repair combined with left atrial appendage occlusion (LAAO) is feasible and safe for patients with atrial fibrillation. This combined approach offers a viable alternative for those contraindicated to oral anticoagulation.
Area of Science:
- Interventional Cardiology
- Cardiac Surgery
- Medical Devices
Background:
- Atrial fibrillation affects 30-50% of patients undergoing percutaneous mitral valve repair.
- Many patients require percutaneous mitral valve repair but have contraindications to oral anticoagulation.
- Left atrial appendage occlusion (LAAO) presents a potential alternative anticoagulation strategy.
Purpose of the Study:
- To assess the feasibility and safety of combining percutaneous mitral valve repair (MitraClip) with LAAO.
- To evaluate technical considerations for the combined MitraClip and LAAO procedures.
- To report multicenter experience with this combined interventional approach.
Main Methods:
- A multicenter study involving six patients treated between April 2012 and April 2016.
- Percutaneous mitral valve repair using the MitraClip system was performed first.
- Left atrial appendage occlusion (LAAO) was subsequently performed in all patients.
Main Results:
- The combined MitraClip and LAAO procedure was successfully performed in all six patients.
- No relevant procedural complications or mortality were observed.
- Mitral valve repair consistently preceded LAAO.
Conclusions:
- The combination of MitraClip and LAAO is a feasible and safe interventional strategy.
- The combined approach demonstrates favorable in-hospital outcomes.
- This technique offers a valuable option for patients with atrial fibrillation and contraindications to anticoagulation.
Background:
Atrial fibrillation is present in 30-50% of patients undergoing percutaneous mitral valve repair. The presence of a formal contraindication to oral anticoagulation is also very common in these patients. In this context, percutaneous left atrial appendage occlusion (LAAO) may be a valid alternative for these patients. The study aim was to assess the feasibility, safety, and technical considerations of the combination of percutaneous mitral valve repair using the MitraClip system and LAAO. The present study describes the multicenter experience of combined MitraClip and LAAO procedures.
Methods:
Between April 2012 and April 2016, six patients were successfully treated with the combined procedure.
Results:
In all patients, mitral valve repair was performed before LAAO. Both procedures were successfully performed in all cases without any relevant procedural complication or mortality.
Conclusions:
According to the results of the present study, a combination of both techniques appears to be feasible and safe, with favorable in-hospital outcomes.