Mitral valve clip is commonly referred to as Mitral Clip in short, can be described as a minimally invasive alternative that can be used for repairing damaged mitral valves. Mitral valve clip procedures enhance the function of your heart in those suffering from mitral regurgitation by decreasing the leakage in mitral valve. Mitral valve clip procedures has proved to be a lifeline to patients who are seeking non-surgical solutions for open-heart surgery for mitral regurgitation, which is the second most common cause of heart disease that affects the valvular valve in the United States behind aortic stenosis.
What Is Mitral Valve Clip Procedure?
Mitral valve clip procedures can be used to repair your mitral valve without opening your heart. While this procedure was initially used for those who were sick or at risk of having open heart surgery today, many patients who have slight to moderate signs and symptoms associated with mitral regurgitation opt to undergo this procedure.
The procedure is carried out percutaneously. This means that the doctor is able to access your heart via one of the veins, typically the groin. A tiny metal clip, coated with polyester fabric, known as the mitral valve clip is placed through your leg, and then guided by a flexible, long tube, referred to as a catheter, up to the mitral valve.
This clip attaches to 2 regions of the valve that is defective, as healthcare professionals refer to it as “edge-to-edge” repair. This permits more blood flow to flow in the correct direction. While a mitral valve clip could significantly reduce regurgitation of the mitral valve, also called mitral valve dysfunction, it is not able to eliminate the problem completely, though patients can notice a significant improvement in symptoms within in the days following the procedure.
Mitral valve clips are typically performed on a scheduled basis. The whole procedure is usually approximately 1 to 3 hours but it may be longer depending on the severity of the procedure.
Contraindications
A mitral valve procedure generally a secured procedure for high-risk surgical candidates. However, there are some who aren’t suitable in the mitral valve procedure. Many healthcare professionals believe the standard open heart surgery is the best for patients with extreme mitral regurgitation symptoms. It is vital to understand that the clip for mitral valve isn’t a cure-all treatment. Therefore, in more severe cases, surgery or replacement is the best alternative.
Mitral valve clips are not advised for those who cannot endure anticoagulation prior to or following the procedure. Other contraindications include:
- Infections on the mitral valve, such as chronic endocarditis in the mitral valve, or mitral valve diseases rheumatic.
- Evidence of an intracardiac, inferior Vena cava, or femoral vein thrombus which would render it difficult to insert the device through the thin catheter tube that is needed to access the mitral valve.2
Potential Risks
A mitral valve procedure can be usually considered secure, however, as with any medical procedure there are dangers. The two most common complications during the procedure are:
- Vascular complications: When pushing with the clip for mitral valve the force exerted in the groin can harm the femoral vein.
- Even patients with moderate mitral regurgitation might require defibrillators or resynchronization placement. The surgeons should be cautious not to move these devices as they advance their clip through the left atrium in the coronary artery.
There could be other problems with the implantation on the clip. Two of the most frequently encountered problems are:
Device attachment with single leaflet (SLDA) it is the most frequently occurring problem and can happen as high as 5 percent of the time. SLDA occurs when the clip remains attached to a single leaflet on the mitral valve following its placement. SLDA is treated because it is identified immediately following surgery or shortly after however, it could be seen even after a month of surgery.
- Embolization of the clip: This happens when the clip breaks off. This is extremely rare, and currently, there are no recommendations for how to fix this, other than performing an operation to eliminate the clip in case it is found in an area that’s hazardous or harmful to the body.
Purpose of Mitral Valve Clip Repair Procedure
If your mitral valve isn’t able to close properly, blood could flow backwards from your left ventricle and into the left atrium and ultimately the lung. The damaged valve doesn’t close properly, hence the term mitral valve dysfunction. The medical condition that develops because of an inadequate or damaged heart valve is called mitral regurgitation.
The backflow and hence increased LA pressures can cause the symptoms that cause dizziness. Shortness or no breath, swelling of feet and legs, referred to as edema and fatigue. If not treated mitral regurgitation may result in an abnormal heartbeat, chest pain and even heart failure.
Mitral valve clip surgery is widely regarded as an initial treatment option for patients at high-risk for surgery. The advantages include:
- A shorter recovery time
- Very minimally invasive
- Significantly less painful than open heart surgery.
- Life-saving procedure for patients with the highest risk of undergoing surgery
If you’re undergoing the mitral valve procedure you should report all medications you’re taking to avoid any serious issues and drug interactions. Your doctor may require you to undergo certain heart tests such as an echocardiogram EKG and X-ray to check the heart’s function prior to performing the procedure.
How to Prepare
The majority of mitral valve clip procedures are performed in the cath lab of hospitals under general anesthesia. Patients at higher risk typically have to spend the night at the hospital in which the procedure is carried out. A change of clothes is recommended for patients who will be staying for the duration of the procedure.
The reason for an overnight stay is to look for signs of complications, as the procedure is relatively quick and non-invasive. Before your procedure, your physician may advise you to put off taking certain medications such as anticoagulants and aspirin that might interfere with the surgery.
Recovery
A majority of patients experience immediate relief from the symptoms of mitral regurgitation after the procedure. Some patients can return back home after a short period of monitoring, while others could require a stay of for a few days or more based on their health. The majority of people will leave following prescriptions for medication.