M U S E U M O F H M H M U LT I M O D A L I T Y I M A G I N G C E N T E R

THREE BIRDS ON A WIRE Stephen H. Little, M.D.; Colin Barker, M.D. Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas

An 89-year-old male presented to Houston Methodist Hospital with dyspnea and fatigue. A 2-dimensional transesophageal echocardiography (TEE) (Panel A) demonstrated prolapse of the posterior leaflet of the mitral valve (pink star). Threedimensional TEE clarified that the prolapse involved only the middle scallop (P2) of the posterior leaflet (Panel B). Mitral valve repair was performed using the MitraClip Clip Delivery System

(Abbott Vascular, Santa Clara, CA). Due to the very large extent of prolapsing tissue, three MitraClip devices (blue arrows) were deployed to reduce his mitral regurgitation severity from severe to mild. The three clips aligned like birds on a wire (Panel C) but created a single tissue bridge with only two diastolic flow orifices (Panel D). The patient reported complete resolution of symptoms after the procedure.

Images submitted by Stephen H. Little, MD and Colin Barker, MD.

MDCVJ 

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XII (1) 2016

houstonmethodist.org/debakey-journal

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Museum Image: Three Birds on a Wire.

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