Tricuspid Replacement and Mitral Valve Repair After a Failed MitraClip to the Tricuspid Leaflets

This video demonstrates a patient who experienced a failed attempt at MitraClip placement on the tricuspid valve. This led to severe tricuspid regurgitation (TR), heart failure, and a dilated mitral annulus that required repair. 

The procedure began with cannulation of the femoral vein, followed by a full sternotomy. Dr. Guadiani then placed a right superior pulmonary vein vent, along with SVC and aortic cannulation for antegrade del Nido cardioplegia.   

After opening the right atrium, the left atrium was accessed through the fossa ovalis, and stay sutures were placed to optimize the view. To repair the functional mitral regurgitation, an annuloplasty ring was used, and no other repair was required.   

The fossa ovalis was then closed and the left atrial appendage was stapled.  

The tricuspid valve was found to be significantly dilated, measuring more than 7 cm, with the MitraClip found hanging off the leaflets.  The clip was removed, and an Abbott 33 mm valve was placed in the tricuspid position.  

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