A Nonsurgical Treatment Option for Mitral Regurgitation

Within the heart, the mitral valve is located between the two left chambers. It functions like a mechanical valve, opening and closing to control circulation and ensure that blood flows in only one direction.

But when the valve’s two tissue flaps, known as leaflets, are damaged, they fail to completely close. This, in turn, can cause blood to leak backward, a condition known as mitral regurgitation.

Roger Laham, MD “Mitral regurgitation places an extra burden on the heart and lungs,” explains Roger Laham, MD (right), Director of the Structural Heart Center in the CardioVascular Institute (CVI) at Beth Israel Deaconess Medical Center (BIDMC). “Symptoms of mitral regurgitation can begin with tiredness and shortness of breath, but if left untreated, decreased blood flow can impede lung function and lead to serious complications.”

These can include heart failure, a serious condition in which the heart fails to pump enough blood to adequately meet the body’s needs.

Surgical and Non-Surgical Treatments

Mitral regurgitation can result from age-related valve deterioration or from damage caused by previous heart attacks, rheumatic fever or untreated high blood pressure.

David Liu, MD Treatment for mitral regurgitation depends on the severity of the condition. “Medications, such as diuretics, might be prescribed to help prevent fluid buildup in the lungs,” says BIDMC cardiac surgeon David Liu, MD (right). “In severe cases, surgery to repair the valve’s faulty leaflets is often recommended.”

However, for frail or elderly patients with severe regurgitation, surgery may not be an option. For these patients, the CVI’s Structural Heart Center offers an alternative nonsurgical treatment called MitraClip Therapy.

In the noninvasive MitraClip procedure, doctors place a tiny clip-like device on the heart’s mitral valve. The clip is positioned by way of a catheter, a tube that is inserted through a vein in the leg and guided into the heart. The device is then left in place and the catheter is removed.

Diagram of MitraClip Therapy“The clip holds the damaged leaflets together so that the valve can close tightly,” explains Laham. “This prevents blood from flowing in the wrong direction.”

90 Percent Success Rate

This past spring, a paper published in the Journal of the American College of Cardiology reported that the MitraClip procedure resulted in a better than 90 percent success rate in reducing symptoms to moderate to low severity in a group of 564 patients with degenerative mitral regurgitation.

“Our Structural Heart Center has been performing the MitraClip procedure since the device was approved by the US Food and Drug Administration [FDA] in 2013,” explains Laham. “Having this extensive experience is critical to successful outcomes.”

MitraClip deviceAlso key to success is the program’s team approach, in which interventional cardiologists and skilled imaging technicians work closely with cardiac surgeons and cardiac anesthesiologists.

“With the aid of sophisticated imaging technology, doctors are able to guide the catheter through the femoral vein in the thigh and into the heart,” says Laham. “The MitraClip is then positioned in the catheter and delivered to the mitral valve, where it is positioned to clasp the valve’s two leaflets and hold them together to correct regurgitation. “

Common Condition

According to Kim Guibone, NP, program coordinator of the Structural Heart Center, the MitraClip procedure takes approximately two to three hours and requires an overnight stay in the hospital.

“As many as 20 percent of Americans over age 55 are believed to have mitral regurgitation,” says Laham. “For patients who are too sick or frail to undergo surgery, the MitraClip Therapy can be a valuable treatment option.”

To make an appointment for evaluation of mitral regurgitation in the Structural Heart Center, call Kim Guibone at 617-632-9729.

Above content provided by the CardioVascular Institute at Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

June 2016

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