{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:07:46Z","timestamp":1761419266858,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,11,15]],"date-time":"2018-11-15T00:00:00Z","timestamp":1542240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Repair of mitral regurgitation (MR) with the MitraClip device (Abbot Vascular, Menlo Park, CA) to treat degenerative MR is associated with improved acute and long\u2010term outcomes. There is an increasing adoption of the device and operators are now testing the limits of the therapy even for unfavorable anatomies. Isolated cleft mitral leaflets are rare but represent a challenge to percutaneous repair. We present two cases of successful repair of severe MR and cleft mitral leaflets. In the first case, a 52\u2010year\u2010old male with a dilated cardiomyopathy and an ejection fraction (EF) of 15% presented in decompensated heart failure. Workup revealed a pseudo\u2010cleft anterior mitral leaflet and a cleft posterior leaflet. A strategy to treat the restricted posterior leaflet lateral of the posterior cleft with a provisional second clip resulted in trace residual MR with only one clip, and an EF improvement to 50% at 2\u2010month follow\u2010up. In the second case, an 80\u2010year\u2010old male with a history of obstructive CAD with a normal EF but severe MR and a restricted anterior leaflet presented with severe shortness of breath. An initial strategy to grasp the middle of the valve was unsuccessful due to the cleft. Instead, two clips were placed side\u2010by\u2010side on either side of the cleft resulting in trivial residual MR. Despite challenging anatomy percutaneous repair can allow for dramatic reduction in MR, resulting in significant left ventricular remodeling and improvement of EF and cardiac output.<\/jats:p>","DOI":"10.1002\/ccd.27980","type":"journal-article","created":{"date-parts":[[2018,11,15]],"date-time":"2018-11-15T16:02:11Z","timestamp":1542297731000},"page":"1161-1164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cleft mitral leaflets and severe mitral regurgitation: Testing the limits of percutaneous mitral valve repair"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2552-6773","authenticated-orcid":false,"given":"Richard","family":"Cheng","sequence":"first","affiliation":[{"name":"Division of Cardiology Cedars\u2010Sinai Heart Institute  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-5958","authenticated-orcid":false,"given":"Saibal","family":"Kar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cedars\u2010Sinai Heart Institute  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Siegel","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cedars\u2010Sinai Heart Institute  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamoo","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cedars\u2010Sinai Heart Institute  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,15]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12303"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24586"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV9I12A238"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV12I9A191"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.07.024"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.11.011"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.06.004"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.07.019"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.01.009"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV12I8A173"},{"key":"e_1_2_5_12_1","first-page":"589","article-title":"Trileaflet mitral valve treated with the MitraClip(R) system","volume":"26","author":"Rodriguez\u2010Santamarta M","year":"2017","journal-title":"J Heart Valve Dis"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu154"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2016.0433"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.27980","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.27980","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.27980","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.27980","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T02:03:49Z","timestamp":1694138629000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.27980"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,15]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1002\/ccd.27980"],"URL":"https:\/\/doi.org\/10.1002\/ccd.27980","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2018,11,15]]},"assertion":[{"value":"2018-07-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}