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Updated: Dec 16, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Percutaneous left ventricular advanced support for 'protected' complex high-risk transcatheter mitral valve repair: a
Iacopo Muraca1, Matteo Pennesi1, Nazario Carrabba1
1Cardiovascular Department, Interventional Cardiology Unit, Careggi University Hospital, Largo Brambilla 3, 50141 Florence, Italy.
Background:
Currently, the use of advanced ventricular support systems during percutaneous mitral valve repair (PMVR) procedures is confined to very few selected cases in emergency or bailout situations. No cases are reported of planned use of ventricular support devices in the subgroup of high-risk patients undergoing PMVR.
Case Summary:
We report two cases of planned and 'protected' procedures of PMVR with Impella CP mechanical circulatory support. No procedure-related complications occurred. At 6-month clinical follow-up evaluation, an improvement of symptoms and functional class (New York Heart Association) was reported.
Discussion:
In the two cases reported, PMVR with Impella CP assistance was feasible, safe and effective in the setting of severe mitral regurgitation associated with dilated and severe left ventricular dysfunction. Extending the concept of 'complex high-risk and indicated patients/procedures' (CHIP) from the environment of coronary intervention, a 'protected' approach could lead to improve technical feasibility and clinical outcome in structural interventions, as advocated for 'protected-percutaneous coronary intervention'.
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