Mitral valve repair after failed MitraClip therapy.

Although the long-term durability of transcatheter procedures has yet to be established, their emergence as an option for mitral valve repair seems to have provided the surgical community with another tool in the toolbox for treatment of mitral valve disease.  Edge-to-edge mitral valve repair (with the MitraClip, Abbott, Abbott Park, IL, USA) was developed as a novel procedure, based on Alfieri's technique, in which the repair can be performed through a percutaneous approach for correction of mitral valve regurgitation. However, with new treatment options, new complications are unavoidable. Mitral valve repair after failed MitraClip therapy can be complex and surgically challenging.  In this video tutorial, we describe a technique for atraumatic removal of the clip, after which adequate repair can be performed.