MitraClip: A New Approach for Managing Valvular Heart Diseases
Mostly valvular heart diseases have been approached with either medication or invasive heart surgery depending on disease severity.
Recently, the interventional cardiology team at the Montreal Heart Institute (MHI) successfully used MitraClip system to treat mitral valve failure. This mitral valve repair system is invented to treat mitral regurgitation patients and reduce the morbidity and mortality related to traditional surgical valve repair or replacement. So far, MHI is the only centre which has used MitraClip system for treating mitral valve failure in Canada.
According to the latest findings from EVEREST II clinical trial conducted by Abbott Vascular and published in The New England Journal of Medicine, MitraClip treatment is safe and effective in improving clinical outcome in New York Heart Association (NYHA) class and quality of life. It also improves left ventricular dimensions. Only fact is that treatment is little bit less effective than traditional surgery at treating mitral valve regurgitation.
Mitral valve failure or mitral valve regurgitation is the commonest type of heart valve defect, in which mitral valve does not close properly when the heart pumps out blood. This results in abnormal leaking of blood from left ventricle into left atrium via incompetent mitral valve.
How Many People Are Affect by Mitral Valve Regurgitation?
It strikes an approximated 1 out 5 people mainly starting at the age of 55. The common causes of mitral regurgitation are mitral valve prolapse (MVP), ischemic heart disease, Marfan syndrome and rheumatic fever.
Patients may be asymptomatic or presented with signs and symptoms of congestive heart failure such as shortness of breath and pulmonary edema.
Presentation of symptoms such as decreased exercise tolerance and palpitations suggest low cardiac output status. In the long run, condition can lead to complications like left ventricle dilation, atrial fibrillation and heart failure.
Echocardiographic finding of gush of blood flowing from the left ventricle into the left atrium during ventricular systole diagnosed Mitral valve disease.
Patients can be managed with medications like vasodilator and additional drugs such as anti-hypertensive and anti-arrhythmic medications as per need. Surgically mitral regurgitation can be approached with Mitral valve replacement or mitral valve repair.
What is the MitraClip System?
MitraClip system is minimally-invasive catheter-based therapy, developed on open surgical double-orifice technique. The clip is a polyester-covered device which repeatedly opened and closed to grasp and approximate the edges of mitral valve leaflets and create a double-orifice mitral valve. During procedure catheter is inserted into the right femoral vein to access the mitral valve of heart, where the Clip Delivery System delivers and implants the MitraClip device. The procedure is conducted under general anaesthesia with uneventful post-procedure recovery period, which is hardly for one to three days.
This procedure is especially designed in inoperable or very high-risk mitral valve failure patients as substitute to heart surgery. The procedure has fewer complications as compared to conventional surgical methods and provides long-lasting effect in acute mitral regurgitation cases.
Dr. Anita Asgar, interventional cardiologist and Assistant Professor in the Faculty of Medicine at Universite de Montreal said:
“All initial cases went well, and we believe that the long-term outcomes for this procedure will be favourable, since it allows patients to regain autonomy and quality of life, we believe that this treatment will reduce the number of hospital admissions and visits to emergency due to symptom recurrence.”