Mitral valve repair in Kansas City

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 cardiologists and cardiothoracic surgeons offer a nonsurgical, minimally invasive approach to mitral valve repair. This procedure is performed at our Heart and Vascular Institute’s Structural Heart Clinic, located at Research Medical Center.

To speak with our Structural Heart Program Coordinator, call us at (816) 276-9050.

An innovative approach to mitral valve surgery

Our team of expert cardiologists, interventional cardiologists and cardiothoracic surgeons collaborate to develop the best treatment plan for each and every patient. Our clinic offers the following features:

  • Advanced procedures – We offer the latest technology and minimally invasive procedures that provide 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.

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
  • Fatigue
  • Swelling of the legs
  • Heart murmur
  • Heart palpitations
  • Chest pain
  • Lightheadedness
  • Fainting
  • Congestive heart failure

Mitral valve regurgitation treatment

Medication may be used to treat the symptoms of mitral valve regurgitation. Still, it can't treat the mitral regurgitation itself because it is a structural issue. Symptomatic moderate to severe mitral valve issues will require treatment beyond medication.

Sometimes complex surgery is needed to repair or replace the valve. These are usually open-heart surgeries that can be used to correct mitral valve regurgitation as well as mitral stenosis. The heart surgeon will either repair the valve or remove the valve leak and replace it with a mechanical or bioprosthetic valve.

Minimally invasive mitral valve repair

The heart surgeons at HCA Midwest also offer minimally invasive mitral valve repair and replacement surgery. In these minimally invasive procedures, the breastbone does not need to be cut and a smaller incision is made, reducing risk to the patient and resulting in a quicker recovery.

Transcatheter mitral valve repair (TMVr)

Our cardiac specialists use MitraClip™ therapy to perform mitral valve repairs and replacements, which offers an alternative for patients who are not candidates for open heart surgery. This is a catheter-based, minimally invasive procedure performed by an interventional cardiologist and a cardiothoracic surgeon.

During the procedure, our physicians will insert a small tube into the femoral vein in the leg and advance the MitraClip™ device 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.

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 (TEE) is used to assess the heart and a stress test or heart catheterization is performed to make sure the arteries are open.

If you have degenerative mitral regurgitation and are 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 you can't tolerate blood thinners or have rheumatic heart disease (thickening of the heart valve with a mix of leaking and stenosis), you probably aren't eligible for TMVr.

As with any procedure, there are risks that you should discuss with your cardiologist. Be sure to speak with your hospital team to make an informed decision about the treatment plan.

The transcatheter mitral valve repair results usually last more than five years. When the disease is expertly diagnosed and treated, patients can experience an improved quality of life and possibly even longer life.

Recovery after a mitral valve clip procedure

After the MitraClip™ is placed, you shouldn’t drive or lift anything over seven to 10 pounds for about one week. After one week, you can get back to your normal activities.

You'll 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 the following milestones:

  • One week after the procedure for a wound check
  • One month for an echocardiogram to see how the valve is working
  • 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.

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.