22 May 2025
Combined LAA closure and transcatheter mitral valve repair - LIVE Case
Mitral valve repair followed by LAA closure in a single procedure
Summary
An 82-year-old male patient with a history of PM (pacemaker) implantation in 2024, and ischaemic cardiomyopathy presented with symptomatic heart failure due to severe secondary mitral regurgitation and impaired LV function (EF 40 %). He also presented with recurrent gastro-intestinal bleeding while on DOAC for atrial fibrillation.
The team first implanted an XTW clip for mitral TEER. Then, they changed the venous sheath (from 24F to 14F) using a tourniquet suture, before implanting a 28 mm Amplatzer Amulet for LAA closure. The procedure was guided by TEE.
LIVE Educational Case from University Medical Center - Mainz, Germany
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Key moments
- 06:00-17:40 - Imaging and procedural analysis
- 20:40-22:44 - Transseptal puncture explanation
- 24:43-46:24 - XTW Clip step-by-step placement
- 48:21-51:09 - Transition phase
- 53:41-1:06:02 - Amplatzer step-by-step placement
- 1:14:20-1:22:38 - Procedural analysis
Keywords: Secondary mitral regurgitation - XTW clip - LAAC - 28 Amplatzer Amulet - Transseptal puncture
Learning Objectives
- To identify patients who are optimal candidates for combined Mitral TEER and LAAC procedures
- To learn the procedural challenges of performing both interventions in a single session
- To gain practical insights on executing each phase of the combined intervention effectively – this in a step-by-step approach
