The Use of Intraprocedural Reinfusion during MitraClip Implantation to Reduce Blood Loss and Transfusion Requirements

BACKGROUND: MitraClip implantation has been shown to reduce mitral regurgitation and is an effective treatment option for patients at high risk for conventional surgery. Blood loss is common during the procedure. We assessed the utility of intraprocedural reinfusion of blood aspirated during MitraClip implantation. METHODS: We compared hemoglobin before and after MitraClip implantation and transfusion requirements in patients who did (n ≤ 83) and did not receive reinfusion (n ≤ 31) during their procedure. For patients who received reinfusion, blood removed during device manipulation was carefully injected back into the patient through the 24 Fr delivery sheath, followed by a saline flush. RESULTS: As expected, patients who received reinfusion had a smaller reduction in hemoglobin post procedure compared to those who did not (0.96 ± 1.0 g/dL vs 1.55 ± 0.94 g/dL; P<.01). There was a trend to lower requirements for blood transfusion in the reinfusion groups (0.39 ± 0.96 units/patient vs 0.15 ± 0.53 units/patient; P<.10). At 30-day follow-up, there was no difference in mortality, stroke, endocarditis, or thromboembolic events between groups. CONCLUSION: Reinfusion of aspirated blood during MitraClip was associated with reduced blood loss and a trend to reduced requirement for blood transfusion post procedure. Reinfusion during the procedure appeared safe, with no complications.