Aranzulla Tiziana Claudia, Civera Stefania, Maffi Lidio, Musumeci Giuseppe
Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy.
Ossigeno Terapia Iperbarica Piemontese (OTIP), Torino, Italy.
Catheter Cardiovasc Interv. 2025 Jul;106(1):581-589. doi: 10.1002/ccd.31600. Epub 2025 May 13.
Arterial gas embolism (AGE) during mitral transcatheter edge-to-edge repair (m-TEER) is a serious event that may lead to catastrophic consequences. Careful preparation and inspection of the device is mandatory, and it is usually performed through a series of standardized steps. However, AGE may come from "hidden" parts of the device. We present the first described case of AGE-related stroke during MitraClip procedure due to a faulty clip introducer, highlighting the importance of the additional inspection of this given-for-granted portion of the device. Hyperbaric oxygen therapy led to complete patient recovery, although performed more than 18 h after the event, leaving place to the benefits of a successful m-TEER procedure. We reviewed the literature and described all the possible sources of AGE during m-TEER with MitraClip, and the intra and postprocedural management of AGE. In particular, hyperbaric oxygen remains the gold-standard treatment for AGE, and it is effective even when performed outside commonly considered time windows of efficacy for ischemic injuries.
二尖瓣经导管缘对缘修复术（m-TEER）期间发生的动脉气体栓塞（AGE）是一种严重事件，可能导致灾难性后果。必须对器械进行仔细准备和检查，通常通过一系列标准化步骤来完成。然而，AGE可能源于器械的“隐蔽”部分。我们报告了首例因夹子导入器故障在MitraClip手术期间发生与AGE相关的中风病例，强调了对该被视为理所当然的器械部分进行额外检查的重要性。高压氧治疗使患者完全康复，尽管是在事件发生18小时后进行的，这也体现了成功的m-TEER手术的益处。我们回顾了文献，并描述了使用MitraClip进行m-TEER期间AGE的所有可能来源以及AGE的术中及术后管理。特别是，高压氧仍然是AGE的金标准治疗方法，即使在缺血性损伤通常认为的有效时间窗之外进行，它也是有效的。
