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Updated: Nov 2, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Emergent valve replacement after circular mapping catheter entrapment in mitral valve apparatus
M N Karabulut1, M Hakan Akay1, Ismael A Salas de Armas1
1Department of Advanced Cardiovascular Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center-Houston, Houston, TX, USA.
Abstract:
We present the case of a 47-year-old male patient with a history of symptomatic paroxysmal atrial fibrillation who failed guideline-directed medical treatment and cardioversion. Electrical mapping was attempted and complicated with catheter entrapping in the mitral valve (MV) apparatus, and multiple attempts for retrieval were unsuccessful and caused severe valvular dysfunction. Emergent valve replacement was required secondary to the extensive disruption of the valvular apparatus and posterior annulus. Mapping catheter entrapment in the valvular apparatus is an uncommon complication, but when it occurs, there is a high risk of injury to the MV apparatus during retrieval. To avoid extensive MV damage, operators should use minimal force during standard manoeuvres to extract the catheter. If gentle retrieval manoeuvres fail, surgical exploration and open retrieval may prevent MV damage. Early surgical consultation and exploration could result in open catheter retrieval or MV repair versus MV replacement.
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