MitraClip® implantation is commonly used in patients with severe mitral regurgitation (MR) and who are at high risk for surgical mitral valve repair. The occurrence of stroke or transient ischemic attack is a potential complication in patients undergoing MitraClip implantation, and incidences of up to 2.6% have been reported. Herein is reported the case of an 84-year-old woman with severe MR and a thin filamentous structure at the rim of the left atrial appendage of unknown etiology. Due to a high surgical risk, the heart team decided to perform endovascular mitral valve repair using the MitraClip procedure. In order to prevent stroke, the implantation procedure was performed using a cerebral protection system.