MitraClip implantation as a new treatment strategy against systolic anterior motion-induced outflow tract obstruction in hypertrophic obstructive cardiomyopathy.

We report on catheter-based treatment of left ventricular outflow tract (LVOT) obstruction targeting primarily a systolic anterior motion of the anterior mitral leaflet in hypertrophic obstructive cardiomyopathy (HOCM). A patient was successfully treated with the MitraClip two years after septal myectomy in conjunction with mitral valve repair. The results prove the concept, that systolic anterior motion (SAM) is clearly involved in gradient formation and is more than an epiphenomenon in HOCM. Thus, SAM-induced subaortic obstruction might be a target for MitraClip implantation.