Transcatheter Mitral Valve Repair (MitraClip™)
MitraClip™ is a less invasive treatment option for mitral regurgitation in individuals who might not be healthy enough for valve replacement surgery.
WHAT IS MITRAL REGURGITATION?
Mitral regurgitation is a condition in which the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward into the heart. Until recently, mitral valve surgery has been the only treatment option for this condition.
SIGNS & SYMPTOMS OF MITRAL REGURGITATION
- Abnormal heart sound (heart murmur) heard through a stethoscope
- Shortness of breath (also called dyspnea), especially when you have been very active or when you lie down.
- Fatigue or tiredness
- Heart palpitations (sensations of a rapid, fluttering heart)
- Swollen feet or ankles
WHAT CAUSES MITRAL REGURGITATION?
The heart has four valves that keep blood flowing in the correct direction. These valves include the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps that open and close once during each heartbeat. If the valve doesn’t open or close properly, this can disrupt blood flow through the heart and through the body.
In mitral valve regurgitation, the valve between the upper left heart chamber and the lower left heart chamber doesn’t close tightly, causing blood to leak backward into the left chamber or atrium.
Possible causes of mitral regurgitation include: Mitral valve prolapse, damaged tissue cords, rheumatic fever, endocarditis, heart attack, abnormality of the heart muscle or cardiomyopathy, trauma, congenital heart defects, certain drugs, radiation therapy, and atrial fibrillation.
Several factors can increase your risk of mitral valve regurgitation including: A history of mitral valve prolapse or mitral valve stenosis, heart attack, heart disease, use of certain medications, infections such as endocarditis or rheumatic fever, congenital heart disease, and age.
WHAT IS THE MITRACLIP PROCEDURE?
The MitraClip™ is a small, metal clip that is implanted through a non-invasive catheter procedure. It prevents regurgitation by clipping and holding a small part of the valve, allowing the valve to close properly and restoring normal blood flow. A catheter is inserted into a vein near the groin and directed to the mitral valve. Once at the valve, the catheter will open and the doctor will place the clip precisely to reduce regurgitation.
Preparing for MitraClip Procedure
Your care team will give you specific instructions to prepare for your MitraClip procedure. They will discuss with you how to prepare for the procedure and what to expect from the procedure. Talk with your care team about any questions or concerns you may have about the procedure.
Before the procedure
In the days before your procedure, it is important that you:
- Take all your prescribed medications
- Tell your doctor if you are taking any other medications
- Make sure your doctor knows of any allergies you have
- Follow all instructions given to you by your doctor or nurse
During the procedure
During the procedure, you will be placed under general anesthesia to put you in a deep sleep, and a ventilator will be used to help you breathe. Your doctor will use fluoroscopy (a type of X-ray that delivers radiation to you) and echocardiography (a type of ultrasound) during the procedure to visualize your heart. On average, the time required to perform the TMVr procedure is between 3 to 4 hours. However, the length of the procedure can vary due to differences in anatomy.
After the procedure
Your hospital stay following the procedure will likely range from 1 to 5 days, depending on your recovery and overall health. You should experience relief from your symptoms of mitral regurgitation soon after your procedure. Most patients will not need special assistance at home following discharge from the hospital, outside of ongoing needs for any unrelated health conditions.
While in the hospital, you will be closely monitored and your doctor will perform various tests to evaluate your heart function. You may be prescribed blood-thinning medications to help reduce the risk of developing a dangerous blood clot after the procedure. Your doctor or nurse will give you instructions about your medications before you leave the hospital.
You will be discharged to the care of your cardiologist or family doctor, who will ask you to return for follow-up visits. It is important that you keep all appointments for follow-up care and follow your doctor’s instructions.
AFTER BEING DISCHARGED FROM THE HOSPITAL, IT IS IMPORTANT THAT YOU:
- Limit strenuous physical activity (such as jogging or activities that cause breath-holding, grunting, or straining such as lifting heavy objects) for at least 30 days, or longer if your doctor thinks it is necessary
- Carefully follow your doctor’s instructions regarding medications you need to take, especially if blood-thinning drugs are prescribed
- Call your doctor if you cannot keep taking your medications because of side effects, such as rash, bleeding, or upset stomach
- Notify your doctor before any medical or dental procedure; you may need to be prescribed antibiotics to avoid potential infection