Mitral clip procedure

The treatment of mitral regurgitation using the catheter technique (MitraClip).

What is a mitral valve leak?
A leaking mitral valve (mitral regurgitation (MR)) is a common heart disease. The mitral valve controls the flow of the blood, which, loaded with oxygen, flows from your lungs through the mitral valve into the left ventricle. When the mitral valve opens, the left ventricle of your heart fills with oxygenated blood. Once this valve closes, the left ventricle pumps blood to all organs of your body.

If the mitral valve does not close properly, blood flows back in the opposite direction toward the lungs. This backflow of blood is called mitral valve leakage (mitral regurgitation). Under these circumstances, the heart has to work much harder to adequately supply the body with blood.

What causes leakage of the mitral valve?
A mitral valve leak may develop in different ways:

  • congenital malformations of the mitral valve
  • age-related changes in the mitral valve
  • degenerative changes of the flap tissue
  • diseases of the heart muscle that may develop after a heart attack or heart insufficiency due to other causes

What can happen if I have a leaking mitral valve?
Many people have a small degree of mitral valve leakage which causes no symptoms and usually does not require treatment. More pronounced leakage of the heart valve, however, leads to strain on the lungs and ultimately on all organs. Frequently, mitral valve leakage leads to significant enlargement of the left atrium, since it has to work much harder over a long period of time than if the mitral valve were healthy. Finally, due to damage to the heart muscle, the condition may lead to severe cardiac insufficiency. At the same time, cardiac arrhythmia may develop.

How do I know that I have a leak in the mitral valve?
Not all people with mitral valve leakage know that they suffer from this cardiac condition. People with mitral regurgitation may suffer from very different symptoms. If the leakage is slight, there may be no symptoms at all. If you suffer from this change in the heart valve structure, it is important that you regularly see a specialist who will perform an ultrasound of your heart valve. Typical symptoms of mitral valve leakage are:

  • tiredness or weakness and shortness of breath during everyday activities
  • loss of appetite
  • dry cough, which often worsens when you lie down 
  • shortness of breath, particularly at night and when lying down
  • brief unconsciousness and blacking out

What treatment options do I have?
If you have a leaking mitral valve, you need to seek the assistance of a specialist who can determine the best treatment. Various cardiac drugs and cardiac surgery methods are available for treating mitral regurgitation. These range from reconstruction to complete replacement of the mitral valve. Mitral valve reconstruction is the best method for curing mitral regurgitation. If the operation is too burdensome or dangerous, the mitral valve can be successfully with catheter techniques.

How does the MitraClip® system for treating mitral regurgitation work?
Using the MitraClip® system, the treating physician inserts a small clip between the two leaflets (sail-like structures) of your mitral valve without having to disturb the heart. Such a clip is placed without opening the chest and without needing a heart-lung machine to provide circulation while the heart is stopped. This is possible because the treating physician can access the left side of the heart with small catheters inserted through your groin. The clip is located at the tip of such a catheter and is placed between the leaflets of the mitral valve using X-ray guidance. As soon as the doctor is sure of the correct position of the clip, the catheter is withdrawn from the heart and the procedure is finished.
 
What are the past treatment results of the MitraClip® system?
The MitraClip® system is a relatively new treatment method. Our team of cardiac specialists has the most experience worldwide with this system. We look back on 150 successful operations. In almost all cases, the system was successfully applied without needing additional treatment methods or surgical procedures.

How long does the procedure take?
The duration of the procedure depends on the individual patient. The system can be utilized within one hour. In more anatomically complex cases, however, this time can be exceeded significantly.

How long will I be hospitalized after such a procedure?
Typically you will spend about 1 to 3 days in the hospital. However, your doctors will determine the length of your hospitalization based on your individual needs and health requirements.

How long will it take before I feel better?
Many patients notice significant improvement in their health immediately after the procedure. This, however, can differ on a case-by-case basis.

Do I need to take certain drugs after the MitraClip® treatment?
In many cases we prescribe blood thinners for some time (e.g., three months) after application of the MitraClip® system. No other drugs are necessary. Drugs you were taking previously may be substantially reduced.

Is there anything in particular I must do after discharge from the hospital?
Usually you can go home without needing any special help. You should, however, avoid strenuous physical activity for approximately 30 days after the procedure.

Please direct your treatment request to the International Office of the University Medical Center Hamburg-Eppendorf.



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