Dr. SENGOTTUVELU G
MD DM DNB FRCP (London), FRCP (Glasgow), FSCAI (USA) FMMC, FACP, FCSI
Fellowship in Interventional Cardiology (France)
Sr. Consultant Interventional Cardiologist,
Apollo Main Hospitals,Chennai
Mitraclip is an advanced, innovative catheter-based technology that makes use of a small clip attached to the mitral valve to treat degenerative mitral regurgitation. MitraClip helps mitral valve to close more completely, thus helping restore normal blood flow through the heart. It is a minimally invasive treatment option for patients with mitral regurgitation (valve leak) who are not good candidates for surgery.
WHAT IS MITRAL REGURGITATION?
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
- Swelling in the legs etc.
WHAT CAUSES MITRAL REGURGITATION?
Mitral valve prolapse: Mitral valve leaflet tissue is malformed and extended so that these 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.
MR can develop as a result of other types of heart diseases, congenital, rheumatic, etc.
HOW THE PROCEDURE IS DONE?
MitraClip procedure is done in the cathlab 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. Transesophageal echocardio- gram aids in the correct placement of the MitraClip. The clip is attached to the mitral valve leaflets, clasping them together firmly and allowing the valve to close better. As soon as the position of the clip is okay with good reduction of valve leak, the clip is released. One or more MitraClips may be used to fix a severely leaky valve. You will be administered with general anesthesia so that you can sleep during the whole procedure with TEE.
HOW DO I KNOW WHETHER I AM A SUITABLE CANDIDATE FOR MITRACLIP?
Critically leaking mitral valve can current be treated by performing repair or replacement of the mitral valve with open heart surgery. If you have many other medical problems, open heart surgery may be too high risk. In such case, Mitral clip may be good option to treat the leaking valve without open heart surgery. The suitability for the mitral clip procedure will be decided by the heart team consisting of cardiologists Dr. Sengottuvelu G, Dr C S Muthukumaran who are leaders in structural interventions 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 I BE BENEFIT FROM MITRACLIP?
The advantage of this minimally invasive procedure compared to open heart surgery is that it enables faster recovery leading to better quality of life. This is a very good alternative for patients who are not candidates for open heart surgery (such as the very old and frail, patients with very weak hearts and those individuals who have other non-cardiac conditions involving kidneys, brain or lungs). Patients who have undergone open heart surgery earlier are also considered for the MitraClip procedure as they may be at higher risk for a re-operation.
- Quicker recovery, less pain and less discomfort
- Minimally invasive as compared to open-heart surgery
- Average stay of patient is 2 – 3 days, however it may vary depending on the condition of patient
- Improvement in the symptoms (shortness of breath and low pressure etc.) of mitral regurgitation can be felt immediately after the procedure
- Improved lifestyle of the patient