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It was reported that a triclip procedure was performed to treat functional tricuspid regurgitation (tr) with a grade of 4 on patient with a restricted septal leaflet, prominent eustachian valve, and trileaflet.A triclip steerable guide catheter (sgc) (60420r1038) and a triclip xtw (50512r1005) clip delivery system (cds) were prepared per the instructions for use (ifu), inserted, and grasping was performed.However, difficulties with imaging occurred.After multiple grasping attempts, leaflet inserted was achieved.However, difficulties with imaging occurred, the leaflets were unable to be deeply seated in the clip arms, and difficulties with trajectory occurred.The cds was reset by removing ¿f ¿ knob and adding minus knob to be parallel with the intra-atrial septum of the superior vena cava (svc).However, a ¿membrane of some sort¿ was observed in the atrium.In the physician¿s opinion, the ¿membrane¿ was not chiari network.At this time, the sgc and the cds were at the original starting point, with the cds approximately 1 ½ inches away from the tip of the sgc.However, tension was encountered, and imaging revealed that the cds had retracted back to the sgc, and was lodged on the tip of the sgc.Troubleshooting was performed but was unsuccessful.Therefore, the sgc and the cds had to be removed together as one unit.The cds was closed completely down, and the sgc and cds were continued for removal as one unit.However, while approaching the femoral vein, it was noted that one of the cds clip arms canted open to approximately 5 degrees.An attempt was then made to close the clip arms tighter, without success.Therefore, vascular surgery was then performed to remove both the sgc and cds at the access point.The groin was preclosed with a preclosure device without further issues.The procedure was discontinued.The patient was reported to be stable throughout the procedure.
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