Endovascular Release of a 50-Year-Old Adams-Deweese IVC Clip to Facilitate Percutaneous Repair of Mitral Valve Regurgitation

Ann Vasc Surg. 2021 Nov:77:353.e1-353.e5. doi: 10.1016/j.avsg.2021.06.008. Epub 2021 Aug 27.

Abstract

Percutaneous mitral valve (MV) repair using MitraClip requires large-caliber venous access. We describe a patient with a ligated inferior vena cava due to an Adams-DeWeese clip placed 50 years prior, who had progressive shortness of breath and lower extremity symptoms secondary to severe mitral regurgitation and chronic iliocaval deep venous thrombosis. Due to comorbidities, MitraClip was recommended over surgery for MV repair. Caval luminal gain was required to facilitate endovascular access for the MitraClip system. Stent-mediated release of the inferior vena cava clip allowed successful passage of the delivery sheath from the common femoral vein to MV and subsequent valve repair.

Keywords: Adams-DeWeese clip; MitraClip; Mitral valve repair; inferior vena cava ligation.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angioplasty, Balloon* / instrumentation
  • Cardiac Catheterization / instrumentation*
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / physiopathology
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Recovery of Function
  • Severity of Illness Index
  • Stents
  • Surgical Instruments*
  • Treatment Outcome
  • Vascular Surgical Procedures / instrumentation*
  • Vena Cava, Inferior / physiopathology
  • Vena Cava, Inferior / surgery*