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.
“Mitral regurgitation places an extra burden on the heart and lungs,”
Roger Laham, MD
(right), Director of the
Structural Heart Center
(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
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.
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
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.
“The clip holds the damaged leaflets together so that the valve can close
tightly,” explains Laham. “This prevents blood from flowing in the wrong
90 Percent Success Rate
This past spring, a paper published in the Journal of the American College of Cardiologyreported 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
Also 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. “
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, contact 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