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Updated: Sep 13, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Electrosurgical Laceration and Stabilization of a Failed Mitral Edge-to-Edge Device Before Transcatheter Mitral Valve
Antonio Mangieri1, Giovanni La Canna1, Andrea Davide Fumero1
1Cardio Center, Humanitas Research Hospital, Rozzano, Milan, Italy.
Background:
Electrosurgical laceration and stabilization of failed MitraClip(s) (ELASTA-Clip) has been proposed as a novel technique to cut the anterior mitral leaflet. A simplified transapical approach has been suggested.
Case Summary:
An 83-year-old man was admitted for recurrent, symptomatic mitral regurgitation after edge-to-edge (ETE) repair with PASCAL due to incomplete closure of the device. A transapical ELASTA failed despite multiple attempts. The procedure was then switched trans-septally and successfully performed without interference with the device. A transapical Tendyne was then implanted without any issue.
Discussion:
The case highlights that ELASTA can fail in case of transapical approach for possible wire impingement in the PASCAL.
Take-Home Message:
Transfemoral ELASTA should be preferred particularly in case of failed ETE due to partial closure of the ETE device.
Related Concept Videos
Mitral Stenosis III: Medical Management
Mitral Regurgitation III: Medical Management

