MitraClip

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What is MitraClip?

MitraClip is a non-invasive procedure that involves using a catheter to place a clip into the heart that attaches to the mitral valves to treat mitral regurgitation.

Mitral regurgitation occurs when the mitral valves in the heart do not open and close properly as blood is pumped through, causing a backflow of blood into the heart. Until recently, the only way to repair mitral valves was through open-heart surgery. MitraClip gives options to those who are not a candidate for open-heart surgery due to age, health issues or other factors. This breakthrough, non-surgical treatment has shown to significantly improve symptoms, slow disease progression and greatly improve quality of life for individuals with mitral regurgitation.

In 2013, MitraClip received approval by the Food and Drug Administration for degenerative mitral regurgitation. In March of 2019, MitraClip received further approval for patients with functional mitral regurgitation. MitraClip remains the most effective treatment available for patients who are not good candidates for traditional surgery.

What is mitral regurgitation?

Healthy mitral valves function as one-way gates that keep blood moving forward through the heart. Mitral regurgitation occurs when the flaps of tissue, or leaflets of the mitral valve do not close completely, allowing blood to leak back from the main pumping chamber into the lung circuit. As a result, the heart works harder to provide adequate blood flow to the body and the backup of blood into the lungs causes difficulty breathing.

If left untreated, mitral regurgitation can be a debilitating, progressive and life-threatening disease that damages the cardiac muscle and raises the risk of arrhythmia, stroke and heart failure. Medications alone will not stop the progression of the disease and will only help to manage symptoms.

It is important to see your doctor if you are experiencing signs and symptoms of mitral regurgitation including:

Shortness of breath
Extreme fatigue
Lightheadedness
Foot and leg swelling
Heart palpitations.

Types of mitral regurgitation

There are two main types of mitral regurgitation:

Degenerative mitral regurgitation: Degenerative mitral regurgitation refers to problems with the structure of the heart valves that causes “leakiness”. These problems can be due to age, an underlying heart condition or a birth defect.
Functional mitral regurgitation: Functional mitral regurgitation refers to heart disease that leads to an enlarged left ventricle, causing diminished functioning.

Dr. Calfon-Press talk about MitraClip Procedure

Non-surgical mitral valve repair

The MitraClip procedure takes about two hours and is performed under general anesthesia. A typical hospital stay is about three days. For some patients, symptoms begin to lessen right away as circulation improves.

The MitraClip, aided by state-of-the-art cardiac imaging, is delivered via catheter to the patient’s heart and mitral valve through the femoral vein. Once positioned and implanted, the tiny clothespin-like device works by permanently clipping together a portion of the leaflets of the valve. The backflow of blood is reduced or eliminated, allowing the heart to pump more efficiently.

Exceptional outcomes and proven success

Multiple clinical trials, published reports and registries of patients treated with the MitraClip have demonstrated marked improvements in mitral regurgitation symptoms and quality of life as well as a decrease in hospitalizations for heart failure for even the most ill individuals.

Analysis of a 2013-2014 nationwide mitral regurgitation registry involving 564 patients showed the MitraClip success rate (defined as a reduction in regurgitation to a level of “moderate” or less) to be 91.8 percent. In a 2018 analysis (COAPT study), the MitraClip procedure and medical therapy has been shown to be superior to a medical therapy only approach in the treatment of functional mitral regurgitation (low ejection fraction); which have since led to the FDA approval for this device.

UCLA’s team approach

UCLA’s dedicated mitral valve repair team works in close partnership with patients, their families and referring physicians to coordinate a an individualized care plan designed to offer the best outcomes. A bi-monthly conference allows access to the entire mitral valve repair team in one visit and location. Individuals are encouraged to ask questions and a detailed review of each patient’s clinical prognosis and personal preferences is discussed. The team offers a same-day consensus and joint recommendation for the most effective treatment strategy.