What is mitral valve regurgitation?
Mitral valve regurgitation is the backward flow of blood into the left heart atrium and lung. This occurs when your heart's mitral valve in the left chamber of your heart does not close tightly when pumping blood. When the mitral valve does not work properly, blood does not move through your heart or to the rest of your body as efficiently as it should, causing you to feel tired or out of breath.
What causes mitral valve regurgitation?
Mitral valve regurgitation can be related to age, a birth defect, or underlying heart disease. Other causes include rheumatic fever, trauma, and long-term use of certain medications. Mitral valve regurgitation is often mild and progresses slowly. You may have no symptoms for decades and be unaware that you have this condition.
How does my doctor determine if I have mitral valve regurgitation?
To determine if you have degenerative mitral valve regurgitation and to assess the function and condition of your heart and mitral valve, your cardiologist may perform diagnostic evaluations including:
- Listening to your heart with a stethoscope
- Using an echocardiogram (ultrasound) to get a close look at your heart and mitral valve
- Taking a chest X-ray to see the size and shape of your heart and evaluate your lungs
- Evaluating you for symptoms of congestive heart failure (such as shortness of breath or fatigue) or other related heart conditions
What can happen if my mitral regurgitation is not treated?
Mitral regurgitation places an extra burden on your heart and lungs. Over time, some people may develop an enlarged heart because it has to work harder to pump blood through the body. If it is not treated, mitral regurgitation can cause other, more serious problems to your heart, such as heart failure, a condition that occurs when your heart can’t pump enough blood to meet the needs of your body.
What is transcatheter mitral valve repair (TMVR)?
TMVR is a minimally invasive procedure that may be an option for patients with degenerative mitral regurgitation who are too sick for surgery. Unlike surgery, this procedure does not require opening the chest and temporarily stopping the heart. Instead, doctors access your heart through a vein in your leg to repair your mitral valve. The MitraClip® procedure is the only TMVR option to treat mitral regurgitation currently approved by the FDA. Your cardiologist will determine if you are a candidate for the MitraClip procedure.
What are the advantages of mitral valve repair?
Advantages include a reduction in hospital readmissions for heart failure, improved lifestyle, and better preservation of heart function.
What is the MitraClip device made of and how does it reduce mitral regurgitation?
The MitraClip device is a small metal clip covered with a polyester fabric that is implanted on your mitral valve. The clip is inserted through a catheter, without the need to temporarily stop your heart.
The MitraClip device treats mitral regurgitation by clipping together a small area of the mitral valve. The valve continues to open and close on either side of the clip. This allows blood to flow on both sides of the clip while reducing the flow of blood in the wrong direction.
How does the MitraClip procedure work?
The MitraClip TMVR procedure works as follows:
- A catheter (thin tube) is inserted through a small incision in the upper leg to reach the heart. The MitraClip device is then guided through this catheter to the mitral valve.
- The MitraClip device grasps the mitral valve flaps to close the center of the mitral valve and reduce mitral valve regurgitation (MR). A second clip may be used for further MR reduction.
- The implanted MitraClip device allows the heart to pump blood more efficiently, relieving symptoms of MR and improving quality of life.
What should I expect after my MitraClip procedure?
The average hospital stay is two to three days. 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, apart from 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.
Following your procedure, you will receive an implant identification card, which you must carry with you at all times. Show your implant identification card if you report to an emergency room or if you require a magnetic resonance imaging (MRI) scan.
How long before I feel the effects of the MitraClip procedure?
Clinical data from patients who have undergone the MitraClip procedure demonstrate an immediate reduction of mitral regurgitation. You should experience improvement in your symptoms of mitral regurgitation and quality of life in the weeks and months following your procedure.
Will I be able to feel the MitraClip implant in my heart?
No, you will not be able to feel the implant.
Will I be prescribed any medications following the MitraClip procedure?
You may be prescribed blood-thinning medications to help reduce the risk of developing a blood clot after the procedure. Your doctor or nurse will give you instructions about your medications before you leave the hospital.
Who should not have the MitraClip procedure?
The TMVR procedure is not right for everyone. Your doctor may decide that the MitraClip procedure is not appropriate for you if you:
- Cannot tolerate medications that thin the blood or prevent blood clots from forming
- Have an active infection or inflammation of the mitral valve
- Have mitral valve disease as a result of rheumatic fever
- Have a blood clot in your heart or in the vessels that carry blood from the lower body to the heart
- Have severe structural damage to the heart valves, preventing the MitraClip deployment
Your doctor should discuss with you if you have any of these issues that would prevent you from having the MitraClip procedure. An evaluation of your heart will also confirm if your heart valve anatomy would allow for successful placement of the device.