Mitral Clip – Breakthrough Innovation for Mitral Regurgitation

Mitraclip is breakthrough innovative catheter-based technology that uses a small clip attached to the mitral valve to treat degenerative mitral regurgitation. MitraClip allows the mitral valve to close more completely, helping to restore normal blood flow through the heart. It’s a minimally invasive treatment option for patients with mitral regurgitation (valve leak) who are not good candidates for surgery.

WHAT IS MITRAL REGURGITATION?

The heart has four valves. These valves regulate blood flow through the heart. The mitral valve which is on the left side of the heart controls blood flow from the atrium to the ventricle. This valve has two leaflets that open and close within the heart ensuring that blood travels in only one direction. Mitral regurgitation is leakage of blood backward to the left atrium through the mitral valve each time when the left ventricle contracts. The mitral valve of the heart does not close tightly enough. This lets some of the blood in your heart flow backward or “regurgitate,” into your heart chamber.

WHAT ARE THE SYMPTOMS OF MITRAL REGURGITATION?

• Shortness of breath
• Fatigue
• Swelling in the legs, etc.

WHAT CAUSES MITRAL REGURGITATION?

• Mitral valve prolapse – mitral valve leaflet tissue is deformed and elongated so that the leaflets do not come together normally
• Functional mitral leak due to poor heart function with dilated chambers after a heart attack or other cause of heart muscle injury.

Mitral Regurgitation can develop as a result of other types of heart diseases, congenital, rheumatic, etc.

HOW THE PROCEDURE IS DONE?

The MitraClip procedure is performed in the cath lab, by inserting a catheter through the groin. The catheter (a long, flexible tube) is inserted into a large vein in your groin (femoral vein) and guided to your heart. It is positioned using trans-oesophageal echocardiogram and X-ray fluoroscopic images. Trans-esophageal echo-cardiogram aids in the correct placement of the MitraClip.

The clip is first attached to the leaflets of the mitral valve, fastening them firmly together and allowing the valve to close better. Once the position of the clip is good with good reduction of the valve leak, the clip is released. One or more MitraClips may be used to fix a severely leaky valve. You will be given general anesthesia so that you can sleep during the entire procedure with TEE.

HOW WILL A PATIENT KNOW WHETHER HE/SHE ARE SUITABLE CANDIDATE FOR MITRACLIP?

The current treatment for severely leaking mitral valve is to perform repair or replacement of the mitral valve with open-heart surgery. If a patient has many other medical problems, open-heart surgery may be too high risk. In such a case, the Mitral clip may be a good option to treat the leaking valve without open-heart surgery. The suitability for the mitral clip procedure will be decided by a heart team consisting of cardiologists along with the cardiac surgeon and cardiac anesthesiologist. Transthoracic echocardiogram (TTE) is an important test to decide suitability and specific measurements of the mitral valve.

HOW WILL A PATIENT BENEFIT FROM MITRACLIP?

The advantage of this minimally invasive procedure compared to open-heart surgery is that it enables faster recovery leading to a better quality of life. This is a very good alternative for patients who are not candidates for open-heart surgery (such as the very frail and old, patients with very weak hearts and those who have other non-cardiac conditions involving the kidneys brain or lungs). Patients who have had open-heart surgery earlier are also considered for the MitraClip procedure as they may be at greater risk for a re-operation.

• Quicker recovery, less pain, and less discomfort
• Minimally invasive as compared to open-heart surgery
• The average stay of a patient is 2 – 3 days, however, it may vary depending on the condition of a patient
• Improvement in the symptoms (shortness of breath and low pressure etc.) of mitral regurgitation can be felt immediately after the procedure
• An improved lifestyle of the patient

Dr. Sengottuvelu G

MD DM DNB FRCP (London) FRCP (Glasgow)

FSCAI (USA) FMMC FACP FCSI

Fellowship in Interventional Cardiology (France)

Sr. Consultant and Interventional Cardiologist,

Apollo Main Hospitals, Greams Lane, Off Greams

Road, Chennai