Observational studyEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2022
Cerebral embolisation during transcatheter edge-to-edge repair of the mitral valve with the MitraClip system: a prospective, observational study.
Observational study in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- The Thromboembolic Continuum in Transcatheter Mitral Valve Repair: A Comprehensive Review.Journal of clinical medicine · 2026Review
- Heart-brain axis pathophysiological understanding and clinical impact.Frontiers in cardiovascular medicine · 2026Review
- Comparison of Cerebral Micro-Embolization Detected by Transcranial Doppler Examination Between Radiofrequency Ablation and Pulsed Field Ablation for Atrial Fibrillation.Journal of cardiovascular electrophysiology · 2025Article
- Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures.Nature reviews. Cardiology · 2025Review
- Cerebral Embolic Protection: Is There a Benefit for Left Atrial and Mitral Valve Procedures?Current cardiology reports · 2024Review
- Limitations in Contemporary Pharmacological Stroke Prevention Therapies in Atrial Fibrillation: A Descriptive Literature Review.Journal of clinical medicine · 2023Review
- Cerebral embolic protection during transcatheter heart interventions.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Review
- Fighting Cardiac Thromboembolism during Transcatheter Procedures: An Update on the Use of Cerebral Protection Devices in Cath Labs and EP Labs.Life (Basel, Switzerland) · 2023Review
- New Cerebral Microbleeds After Catheter-Based Structural Heart Interventions: An Exploratory Analysis.Journal of the American Heart Association · 2023Observational
- Complications following transcatheter edge-to-edge mitral valve repair: Personal experience and review of the literature.Cardiology journal · 2023Review
- Cerebral embolism during transcatheter mitral valve repair: not so silent after all?EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022Article
- Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures.Medicina (Kaunas, Lithuania) · 2021Review
Corrections and comments
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Authors and funding
19 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNew ischaemic brain lesions on magnetic resonance imaging (MRI) are reported in up to 86% of patients after transcatheter edge-to-edge repair of the mitral valve (TEER-MV). Knowledge of the exact procedural step(s) that carry the highest risk for cerebral embolisation may help to further improve the procedure.
aimsThe aim of this study was to identify the procedural step(s) that are associated with an increased risk of cerebral embolisation during TEER-MV with the MitraClip system. Furthermore, the risk of overt stroke and silent brain ischaemia after TEER-MV was assessed.
methodsIn this prospective, pre-specified observational study, all patients underwent continuous transcranial Doppler examination during TEER-MV to detect microembolic signals (MES). MES were assigned to specific procedural steps: (1) transseptal puncture and placement of the guide, (2) advancing and adjustment of the clip in the left atrium, (3) device interaction with the MV, and (4) removal of the clip delivery system and the guide. Neurological examination using the National Institutes of Health Stroke Scale (NIHSS) and cerebral MRI were performed before and after TEER-MV.
resultsFifty-four patients were included. The number of MES differed significantly between the procedural steps with the highest numbers observed during device interaction with the MV. Mild neurological deterioration (NIHSS ≤3) occurred in 9/54 patients. New ischaemic lesions were detected in 21/24 patients who underwent MRI. Larger infarct volume was significantly associated with neurological deterioration.
conclusionsCerebral embolisation is immanent to TEER-MV and predominantly occurs during device interaction with the MV. Improvements to the procedure may focus on this procedural step.
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