Minimally invasive mitral valve repair – for an improved quality of life.
A leaky mitral heart valve can cause symptoms that greatly impact a person’s quality of life. They may have trouble doing the things they love or even performing everyday tasks. Luckily, progress continues to be made with new and innovative treatment options becoming available to more people.
At HCA Midwest Health, our Kansas City interventional cardiologists and cardiothoracic surgeons offer a non-surgical, minimally invasive approach to mitral valve repair. This procedure is performed at the HCA Midwest Health Heart & Vascular Institute’s Structural Heart Clinic, located at Research Medical Center.
- A team approach to care – Our team of expert cardiologists, interventional cardiologists and cardiothoracic surgeons collaborate to develop the best treatment plan for each and every patient.
- Advanced procedures – We offer the latest technology and minimally invasive procedures such as the mitral valve clip that provides an option to people who were previously told that surgery is too risky.
- One convenient office visit – Whenever possible, we conduct testing, review of all results and development a treatment plan in one, convenient office visit.
- Personalized care – We are committed to treating every patient the way we would treat our own loved one. Your wants, needs and lifestyle will always be taken into account.
Patients can be referred to the HCA Midwest Health Heart & Vascular Institute Structural Heart Program by a primary care physician or cardiologist. To speak with our Structural Heart Program Coordinator:
What is mitral valve regurgitation?
The mitral valve is the valve that separates the left atrium (upper heart chamber), which fills with blood from the lungs, from the left ventricle (lower heart chamber), which pumps and pushes blood out to the aorta. Mitral regurgitation or mitral valve insufficiency is when the mitral heart valve doesn’t close completely causing blood to flow backward into the left atrium instead of going out to the brain and other organs.
There are two types of mitral regurgitation:
- Primary MR (degenerative MR) – Degenerative mitral valve disease means that the leaflets or flaps of the valve are damaged or torn due to wear and tear. Treatment options for this include open heart surgery or transcatheter mitral valve repair using the MitraClip.
- Secondary MR (functional MR) – Functional mitral valve regurgitation means that the function of the heart walls is not normal. The actual leaflet of the valve is not damaged, but the valve could be leaking because of a cardiac event such as a heart attack. This type of disease is usually treated with heart failure medication first. The person may also need a stent or a pacemaker. The MitraClip procedure would be the last step in treatment and preferred over open heart surgery.
Symptoms of MR include:
- Shortness of breath
- Swelling of the legs
- Heart murmur
- Heart palpitations
- Chest pain
- Congestive heart failure
Mitral valve regurgitation treatment
Medication may be used to treat the symptoms of MR, but it cannot treat the mitral regurgitation itself because it is a structural issue. Symptomatic moderate to severe MR will require surgery or a minimally invasive non-surgical procedure.
Transcatheter mitral valve repair (TMVr) (MitraClip)
Transcatheter or percutaneous mitral valve repair is a catheter-based, minimally invasive procedure performed by an interventional cardiologist and a cardiothoracic surgeon.
During the procedure, your physicians will insert a small tube into the femoral vein in the leg and advance the MitraClip to your heart. While the heart is beating, the doctor will position the Mitraclip at the area of the leak and grab the mitral leaflets to bring them together and reduce the leak.
Blood thinners will need to be stopped for a couple days before a TMVr. You will be under general anesthesia and a transesophageal echocardiogram is used to help the cardiologists with visualization. It is a low risk procedure with a quick recovery that takes about two hours to complete. Most people are up and walking in about six hours and leave the next day.
Is the mitral valve clip right for me?
A team of cardiologists, interventional cardiologists and cardiac surgeons collaborate to evaluate each patient to see if they are a candidate for open heart surgery. A transesophageal echocardiogram is used to assess the heart, and a stress test or heart catheterization to make sure the arteries are open.
If someone has degenerative mitral regurgitation and is not a good candidate for open heart surgery, the heart team would recommend TMVr with the MitraClip. For secondary mitral valve regurgitation, the preferred treatment is usually TMVr.
If someone cannot tolerate blood thinners or has rheumatic heart disease (thickening of the heart valve with a mix of leaking and stenosis) they are not eligible for TMVr.
As with any procedure, there are risks that should be discussed with your cardiologist. Be sure to speak with your hospital team so you can make an informed decision about the treatment plan.
After the MitraClip is placed you shouldn’t drive or lift anything over seven to ten pounds for about one week. After one week, you can get back to your normal activities.
You will need to remain on blood thinners for about three months. Your heart care team will give you specific follow-up instructions, but generally you will need to see your interventional cardiologist at about one week post procedure for a wound check, at one month for an echocardiogram to see how the valve is working and at six months before going back to your general cardiologist.
The transcatheter mitral valve repair results usually last more than five years. When expertly diagnosed and treated, patients with mitral valve disease can experience an improved quality of life and possibly even a longer life.
To find out if the percutaneous mitral valve clip is an option for you, talk to your doctor or cardiologist about a referral to the HCA Midwest Health Structural Heart Clinic located at Research Medical Center.
Mitral valve surgery
During surgery the valve can either be repaired or replaced. These are open heart surgeries that can be used to correct mitral valve regurgitation as well as mitral stenosis. During the surgery the breastbone is cut and a heart-lung machine is used so that blood and oxygen can continue to flow through the body while the heart is repaired. The heart surgeon will either repair the valve or remove the valve leak and replace it with a mechanical or bioprosthetic valve.
The heart surgeons at HCA Midwest Health also offer minimally invasive mitral valve repair and replacement surgery. This means that for some people, the breastbone does not need to be cut and a smaller incision can be made to help minimize recovery time.
Transcatheter mitral valve replacement (TMVR)
If you previously had surgery to replace your mitral valve with a bioprosthetic valve and that valve is failing, but a repeat surgery is deemed too risky, TMVR may be an option. Transcatheter mitral valve replacement is a minimally-invasive, catheter-based procedure for replacing a bioprosthetic mitral valve. An interventional cardiologist and cardiothoracic surgeon perform the procedure using a catheter inserted into the femoral vein. A new valve is placed within the old damaged bioprosthetic valve.