Stroke and thrombus formation appending to the MitraClip: what is the appropriate anticoagulation regimen?

Percutaneous mitral valve repair with the MitraClip system (Abbot Vascular, USA) is a promising technique for the non-surgical treatment of mitral regurgitation in special situations. The case is reported of a 72-year-old patient with history of atrial fibrillation and a severely impaired left ventricular function who underwent successful MitraClip implantation because of functional mitral regurgitation grade 3. The patient's post-interventional course was complicated three weeks later by a cardioembolic stroke due to thrombus formation on the MitraClip, despite receiving dual platelet therapy.