MUSEUM OF HMH MULTIMODALITY IMAGING CENTER
Stephen H. Little and Colin Barker. Three Birds on a Wire. Methodist DeBakey Cardiovascular Journal. January 2016, Vol. 12, No. 1, pp. 55-55.doi: https://doi.org/10.14797/mdcj-12-1-55
transesophogeal echocardiography , mitral regurgitation , leaflet prolapse
An 89-year-old male presented to Houston Methodist Hospital with dyspnea and fatigue. A 2-dimensional transesophageal echocardiography (TEE) (Panel A) demonstrated prolapse of the posterior leaflet of the mitral valve (pink star). Three-dimensional TEE clarified that the prolapse involved only the middle scallop (P2) of the posterior leaflet (Panel B). Mitral valve repair was performed using the MitraClip Clip Delivery System (Abbott Vascular, Santa Clara, CA). Due to the very large extent of prolapsing tissue, three MitraClip devices (blue arrows) were deployed to reduce his mitral regurgitation severity from severe to mild. The three clips aligned like birds on a wire (Panel C) but created a single tissue bridge with only two diastolic flow orifices (Panel D). The patient reported complete resolution of symptoms after the procedure.