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Updated: Nov 1, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Interatrial Thrombus in Left-Atrial Septal Pouch Prohibiting Transseptal Puncture for Percutaneous Mitral Valve
Muhammed Gerçek1, Masathoshi Hata2, Jan Gummert2
1Clinic for General and Interventional Cardiology/Angiology, Herz-und Diabetezentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Abstract:
An 82-year-old female patient with severe mitral regurgitation was referred for evaluation of percutaneous mitral valve repair. Transoesophageal echocardiography revealed a left-atrial septal pouch (LASP) with an echogenic structure. Following the heart-team decision, interventional therapy was therefore discarded. During surgery, a thrombus in the LASP was found and carefully resected. Afterward, conventional valve replacement with a biological 31-mm SJM-EPIC prosthesis (Abbott Structural Heart Devices, Santa Clara, CA) was performed. In the fast-evolving field of interventional mitral valve therapy, a trans-septal approach is the common strategy. Therefore, careful evaluation of the interatrial septum-which may contain thrombi with transoesophageal echocardiography before intervention-is of crucial importance.
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