What Is MitraClip® Therapy?
The MitraClip procedure is a treatment for patients who have symptoms of heart failure and shortness of breath due to leaking through the mitral valve.
The procedure is performed through a very small incision in the groin. A small tube, or catheter, is advanced through the vein in the leg, up to the heart, and through this tube a clip is placed across the leaking portion of the valve.
Who Is Eligible for the MitraClip Procedure?
Surgery is the gold standard therapy for patients who have severe leak through the mitral valve due to a structural abnormality in the valve. It offers the best reduction in the leak and superior long-term durability. However, not all patients are good candidates for open heart surgery: older patients or patients with other significant medical problems may be at a higher risk for surgery. For these patients, Transcatheter Mitral Valve Repair (TMVR) has emerged as an excellent alternative therapy. It is intended for patients who have a structural abnormality of the mitral valve that causes the leaking, or mitral regurgitation.
In addition, patients may have a structurally normal valve but still have severe mitral regurgitation, because of a weakened heart muscle, or prior heart attack. In these patients, MitraClip (in addition to optimal medical therapy) has been shown to significantly improve symptoms and reduce mortality.
Patients with mitral regurgitation frequently have symptoms like shortness of breath, easy fatiguing, heart rhythm difficulties such as atrial fibrillation, and symptoms similar to heart failure.
The following patients are candidates for the MitraClip procedure:
- Patients who have symptoms due to primary mitral regurgitation, who are not good surgical candidates
- Patients with significant mitral regurgitation due to a weakened heart muscle, who have persistent symptoms of heart failure, fatigue, and shortness of breath despite optimal medical therapy
- Patients felt to be high risk for surgery (the MitraClip therapy does not require open heart surgery, and it has a short recovery time)
What Else Should I Know about It?
The procedure usually only takes one to two hours. Recovery in the hospital usually only takes one to two days. Patients treated with the MitraClip TMVR have shown improved quality of life, decreased heart failure symptoms, and decreased hospitalization for heart failure.
Prior to undergoing TMVR, patient should expect:
- A comprehensive evaluation by the Heart Valve Team, which includes cardiologists and cardiac surgeons. The advantage to a patient-centered, collaborative treatment team ensures that all patients receive the best treatment available, whether it is optimal medical therapy, surgical valve repair or transcatheter valve repair
- Each patient will undergo a transesophageal echocardiogram (TEE) which is an ultrasound performed under light sedation, similar to endoscopy. During this test, patients swallow a small tube, which contains an ultrasound probe; ultrasound pictures are performed of the heart, from the patient’s esophagus. This is the best study to identify exactly where the valve is leaking, and whether the clip will be an effective treatment.
- Patients often will undergo left heart catheterization prior to the valve procedure, to ensure that there are no critical blockages in the heart arteries which could be contributing to symptoms, or which could complicate the procedure.