A case of successful Mitraclip implantation in a patient having a large coaptation gap under extracorporeal membrane oxygenation (ECMO).

Mitraclip is an alternative therapeutic option for severe functional mitral regurgitation (MR) with reduced ejection fraction, especially in patients with high surgical risk. Although the Mitraclip was reported as an effective therapy in patients who fulfilled the anatomical criteria of the EVEREST trial, it is still uninvestigated whether the therapy is also feasible and beneficial in patients outside the indication criteria of the EVEREST II trial. Among them, MR with a large coaptation gap is considered as a challenging anatomy, because the gap makes it difficult to grasp both leaflets with a standard Mitraclip procedure. As two techniques to grasp such a large coaptation gap were reported, there was no report concerning the effectiveness of extracorporeal membrane oxygenation (ECMO) during Mitraclip implantation. Here we present a first case of successful Mitraclip implantation in a patient with a large coaptation gap with the support of ECMO. © 2016 Wiley Periodicals, Inc.