MitraClip®

The MitraClip is a transcatheter mitral valve therapy, also referred to as transcatheter mitral valve repair (TMVr), used to treat degenerative mitral regurgitation (MR). Currently approved and yielding excellent results for primary MR patients who are not operative candidates. MitraClip was shown, according to a recently published COAPT trial, to be effective as well in the treatment of functional MR in a certain patient population.

An alternative to traditional open heart mitral valve surgery, the dime-sized MitraClip device is attached to a patient’s mitral valve through a catheter (a hollow, flexible tube slightly larger than the diameter of a pencil), which is guided through a vein in the leg to reach the heart.

The Procedure

The clip, which is attached to the end of a clip delivery system, is guided to the mitral valve with the help of imaging equipment. The physician implants the clip at the appropriate position on the mitral valve. The clip will grasp the mitral valve leaflets to close the center of the mitral valve and reduce mitral regurgitation (MR). Tests are performed to confirm that the clip is working properly. In some cases, a second clip may be implanted for further reduction of MR.

Once the clip is in place and working properly, it is disconnected from the clip delivery system. It, along with the guide catheter, are then removed and the small incision in the patient’s leg is closed.

The implanted clip becomes a permanent part of the heart, allowing the mitral valve to close more tightly and reduce the backward flow of blood.

Following the Procedure

Following the MitraClip procedure, patients will remain in the hospital one to five days, depending on individual recovery and overall health. Relief from MR symptoms should be felt soon after the procedure. While in the hospital various tests are performed to evaluate heart function. Patients may be prescribed blood-thinning medications to help reduce the risk of blood clot.

Once discharged from the hospital it is important that patients:

  • Limit strenuous physical activity (such as jogging or activities that cause breath-holding, grunting, or straining such as lifting heavy objects) for at least 30 days, or longer depending physician assessment.
  • Carefully follow instructions regarding medications.
  • Call if side effects from medications prompt their discontinued use.
  • Notify your physician before any medical or dental procedure, as antibiotics may be prescribed to avoid potential infection.

According to clinical data, patients who underwent the MitraClip procedure demonstrated an immediate reduction in mitral regurgitation and a low hospital length of stay of 1-2 days. Significant improvement in MR symptoms and quality of life are reported following the procedure [1].

MitraClip Procedure Step-By-Step

References

  1. CMS 42 CFR Parts 405, 412, 413, and 485 [CMS-1655-F; CMS-16644-F; CMS-1632-F2] RIN 0938-AS77; 0938-AS88; 0938-AS41 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates. (Worldwide data as of July 2017, on file at Abbott).