Left Ventricular Assist Device Insertion in a Patient With MitraClip: Remove Clip or Leave It? A Case Report

Area of Science:

• Cardiology
• Anesthesiology
• Medical Devices

Background:

• Increasing use of mitral transcatheter edge-to-edge repair (mTEER) in heart failure patients.
• Patients with mTEER devices may require left ventricular assist device (LVAD) implantation.
• Potential for mTEER devices to impact LVAD procedures.

Purpose of the Study:

• To highlight the importance of intraoperative echocardiography in patients undergoing LVAD with prior mTEER.
• To identify potential pitfalls in interpreting echocardiographic findings in this complex scenario.
• To guide cardiac anesthesiologists in decision-making regarding mTEER devices during LVAD surgery.

Main Methods:

• Review of clinical scenarios involving mTEER and LVAD.
• Analysis of intraoperative echocardiographic considerations.
• Discussion of potential interpretation errors and their implications.

Main Results:

• Echocardiographic interpretation in mTEER patients undergoing LVAD can be challenging.
• Specific caveats must be considered to avoid erroneous assessments.
• Accurate interpretation is crucial for guiding surgical decisions.

Conclusions:

• Cardiac anesthesiologists play a vital role in managing patients with both mTEER and LVAD.
• Awareness of mTEER device impact on echocardiography is essential for safe LVAD implantation.
• Further education on managing these complex cases is warranted.