Know your interventions: the mitral clip

One of the main causes of heart problems is mitral valve regurgitation (MVR), also called mitral insufficiency. The mitral valve consists of flaps or cusps that separate the left auricle and left ventricle of the heart. A chronic MVR is “a long-term disorder in which the heart’s mitral valve does not close properly, causing blood to flow backward (leak) into the upper heart chamber when the left lower heart chamber contracts. The condition is progressive, which means it gradually gets worse.”

Currently, the standard intervention for MVR is an open heart surgery to fix the valve. However, a less invasive alternative may now be available, an intervention that is also risky and facilitates faster recovery. The new intervention, called percutaneous valve therapy, uses a catheter that is inserted through a blood vessel in the groin up to the heart. A small device, a mitral valve clip, is inserted through the catheter. The clip grasps and tightens the leaflets of the valve, pulls them together and approximates them to reduce leaking. The whole procedure takes two hours, the same duration of an open heart surgery.

The symptoms of MVR, according to Dr. George Hanzel, an interventional cardiologist at William Beaumont Hospital in Royal Oak, Michigan,

“A lot of these patients have shortness of breath. The main thing they have is fatigue, exercise intolerance, shortness of breath and swelling.”

When left untreated, mitral insufficiency can lead to progressive enlargement of the left ventricle, and eventually heart failure.

The mitral valve clip intervention has the following advantages:

• It can be used in patients who are too weak to undergo surgery.
• Patients recover more quickly – in weeks rather than months.
• There are usually less complications.

Currently, the mitral clip procedure is not a standard intervention in the treatment of MVR. It is still in the experimental phase, being tested in several clinical trials.

The most commonly used clip is the Mitra Clip. Preliminary data from trials on the Mitra Clip suggests improved heart function. Last year, results from the Endovascular Valve Edge-to-Edge Repair STudy (EVEREST), indicated a good safety and efficacy profile.

Currently, the trend in medicine is finding less invasive ways of treating illnesses. The message is clear: cutting up is not always the answer.

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