Link to Öztürk et al. EHJ Cardiovascular Imaging (Full text available free)
This case depicts a rare anatomical condition: an MV pseudo-cleft caused by severe tension on the posterior leaflet tip due to asymmetric left ventricular dilatation. 3D echocardiography was of great value to clarify the underlying pathoanatomy and to exclude prohibitive anatomical condition. Therefore, MitraClip implantation was a valuable treatment option in this high-risk patient. However, the MitraClip procedure should not be regarded as first-line treatment in patients with supposedly adverse anatomy; such procedures should be performed in experienced high-volume centres.