Acute tricuspid valve remodeling after MitraClip deployment: rationale for a dual-staged procedure.

Abstract A 70-years-old woman was admitted to our hospital for severe tricuspid regurgitation due to cardioverter-defibrillator lead impingement; treatment with MitraClip system was attempted. After realizing the impossibility of grasping in the regurgitant area because of extensive leaflets gap, we implanted a clip in another commissure even in the absence of regurgitation originating from that area. In this way we achieved a significant acute valve remodelling which allowed the subsequent successful deployment of a second clip in the regurgitant area. This dual-staged approach proposed can be considered systematically for the treatment of anatomies generally regarded as unfavourable or unsuitable.