Impella-Clip: a secure and effective strategy in cardiogenic shock due to acute severe mitral regurgitation. How would I approach it?

As in the case presented here, these are often inferior or inferior-posterior wall myocardial infarctions due to the occlusions of very-well developed left circumflex arteries or very dominant right coronary arteries. These are high-surgical risk patients following their poor clinical and hemodynamic situation. Although, traditionally, the only possible procedure for these patients was mitral valve repair or replacement surgery, surgical results are associated with a high in-hospital mortality rate due to both these patients’ unstable clinical situation and procedural complications.1