Transcatheter Electrosurgical Laceration and Stabilization of Failed MitraClip[s]/SAPIEN M3 for Treatment of Failed MitraClip

Inci, Errol; Greenbaum, Adam; Lederman, Robert J.; Kohli, Keshav; Lisko, John; Byku, Isida; Gleason, Patrick; Xie, Joe; Shekiladze, Nikoloz; Babaliaros, Vasilis

doi:10.1161/circinterventions.122.012014

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“…In patients with prior surgical Alfieri stitch (electrosurgical laceration of alfieri stitch 60 ) or transcatheter edge-to-edge repair (ELASta-Clip; E lectrosurgical L aceration A nd St abilization of failed Mitra Clip (s) 61,62 ), positioning of the Flying-V on the anterior mitral valve leaflet anteriorly, adjacent to the suture- or leaflet-bridge, liberates the leaflets upon electrosurgical laceration (Figure 5). This procedural adjunct enables TMVR devices to pin the suture or clip harmlessly and posteriorly along with the posterior mitral leaflet.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Transcatheter Electrosurgery: A Narrative Review

Bruce

Khan

Rogers

et al. 2023

Circ: Cardiovascular Interventions

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Transcatheter electrosurgery describes the ability to cut and traverse tissue, at a distance, without an open surgical field and is possible using either purpose-built or off-the-shelf devices. Tissue traversal requires focused delivery of radiofrequency energy to a guidewire tip. Initially employed to cross atretic pulmonary valves, tissue traversal has enabled transcaval aortic access, recanalization of arterial and venous occlusions, transseptal access, and many other techniques. To cut tissue, the selectively denuded inner curvature of a kinked guidewire (the Flying-V) or a single-loop snare is energized during traction. Adjunctive techniques may complement or enable contemporary transcatheter procedures, whereas myocardial slicing or excision of ectopic masses may offer definitive therapy. In this contemporary review we discuss the principles of transcatheter electrosurgery, and through exemplary clinical applications highlight the range of therapeutic options offered by this versatile family of procedures.

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Section: Clinical Applicationsmentioning

confidence: 99%