MitraClip-induced systolic anterior motion complicated by pericardial effusion: A case report

Amos Levi, Alexander Sagie, Ran Kornowski

Research output: Contribution to journalArticlepeer-review


Systolic anterior motion (SAM) of the anterior mitral leaflet is a well reported complication of surgical mitral valve repair (MVR). In the current report, we present a case of SAM with left ventricular outflow tract obstruction (LVOTO) which occurred after transcatheter mitral valve repair (TMVR) using the MitraClip device. LVOTO was caused by the combination of protrusion of the MitraClip device into the LVOT and underfilling of the left ventricle due to pericardial effusion and atrial fibrillation. Rapid clinical resolution and marked decline in LVOT pressure gradient occurred following surgical drainage and windowing of the pericardium. We conclude that SAM and LVOTO could occur after TMVR. Seeking and addressing reversible aggravators of LVOTO including pericardial effusion is essential and could potentially make the difference between a successful procedure and a failed one.

Original languageEnglish
Pages (from-to)1371-1374
Number of pages4
JournalCatheterization and Cardiovascular Interventions
Issue number7
StatePublished - 1 Jun 2018


  • complications
  • mitral clip
  • percutaneous mitral valve repair


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