Transapical Retrieval of an Embolized Valve During Transcatheter Mitral Valve Replacement Using a Retrieval Basket

To describe a transcatheter mitral valve replacement case complicated by valve embolization into the left ventricle (LV) retrieved with the ŌNŌ (ŌNŌCOR LLC) retrieval basket via a transapical approach.

Maintain wire position. Cannulate for venous-arterial extracorporeal membrane oxygenation. Perform left lateral thoracotomy at the fifth intercostal space and LV apex access. Advance a 21-F Certitude sheath (Edwards Lifesciences) over Amplatz Extra Stiff Wire (Cook Medical). Advance a 12-F ŌNŌ retrieval system through the sheath. Use grasping device and forceps (Raptor) to secure the valve in the basket.

Maintaining wire position is critical when a transcatheter mitral valve replacement valve has embolized to prevent movement and possible LV outflow tract obstruction.

A transapical approach using the ŌNŌ retrieval basket is a less invasive alternative for embolized TMVR valve retrieval in high-risk patients.