Acute Tricuspid Valve Remodelling After MitraClip Deployment: Rationale for a Dual-Staged Procedure.

A 70-year-old woman was admitted to our hospital for severe tricuspid regurgitation caused by cardioverter-defibrillator lead impingement; treatment with MitraClip system (Abbott Vascular, Santa Clara, CA) was attempted. After realizing the impossibility of grasping in the regurgitant area because of extensive leaflets gap, we implanted a clip in another commissure, even in the absence of regurgitation originating from that area. In this way, we achieved a significant acute valve remodelling, which allowed the subsequent successful deployment of a second clip in the regurgitant area. This proposed dual-staged approach can be considered systematically for the treatment of anatomies generally regarded as unfavourable or unsuitable.