It’s the most common type of heart valve disease: mitral regurgitation, also known as a leaky mitral heart valve. While this condition can lead to serious health problems, it is treatable – even more so these days due to a minimally invasive procedure using the MitraClip. This FDA-approved device allows physicians to fix faulty heart valves without doing open heart surgery.
In this episode of San Diego Health, Matthew Price, MD, an interventional cardiologist at Scripps Clinic, joins host Susan Taylor to discuss mitral valve disease and the catheter-based procedure used to correct the problem.
“It’s one of the miracles of modern medicine,” Dr. Price says. “With the MitraClip procedure, patients go home the next day.”
Heart valve disease can be congenital or acquired during one’s lifetime.
The four valves in the heart are supposed to keep blood flowing freely in a forward direction and prevent backward leakage. Heart valve disease occurs when the heart's valves fail to work the way they should and put a strain on the heart.
The mitral valve contains two flaps known as mitral leaflets whose purpose is to open and close tightly. When the leaflets become damaged and no longer seal completely, blood can flow backward, making the heart work harder than normal. Over time, larger leaks can lead to shortness of breath, fatigue and heart failure. Patients also face an increased risk of irregular heartbeat, stroke and heart attack.
“If you have a leaky mitral valve, what happens is when your heart squeezes, instead of blood going forward to your brain and your muscles, the blood goes backward toward the lungs,” Dr. Price says.
“If you have a severe leak, you can get short of breath. Your heart can enlarge and get weak. You could feel tired, gain weight and have problems breathing even doing very simple tasks,” Dr. Price says.
The MitraClip device fixes valve leaks by clipping together the leaflets of the valve at the spot where they are not coming together correctly. The interventional cardiologist inserts a thin tube called a catheter into a leg vein, guides it up to the heart, then guides the MitraClip through the catheter and carefully positions it on the mitral valve.
“It stays there forever,” says Dr. Price, who was involved in the clinical trials that led to FDA approval. “We have data that shows that it is durable after implantation.”
The MitraClip is generally reserved for patients who are not good candidates for open heart surgery due to their age, frailty or the presence of other health conditions.
“These are patients who in the past we’d be very worried about operating on,” Dr. Price says. “The great thing about the MitraClip is patients are going home afterward. They’re not going to the rehab facility. They’re not in the hospital for weeks. That’s really an important thing.”
A heart-team approach is taken to determine who is a candidate for the MitraClip.
“It’s a fairly comprehensive evaluation. We do a whole host of tests,” Dr. Price says. “Patients see not only me, but also a cardiac surgeon, and often a heart failure physician, as well. For each patient, we decide as a team whether a MitraClip is the right solution.”