The MitraClip is a fairly complex device. It looks like a clothespin more than a clip. What’s really neat is that this clip has two arms that open and close. One of the arms grabs what’s called the anterior leaflet and the other arm grabs the posterior leaflet.
What I do is advance this clip through the heart and underneath the leaflets of the mitral valve. Then I retract the arms just a little bit to make a V and pull back on the clip until the two leaflets rest very nicely in those arms. When I see, using a special echocardiogram or ultrasound, that I’ve got both of those leaflets, I drop the grippers. Once I’ve grabbed the leaflets, I’m retract the arms and grab them.
I’ve now brought those leaflets together where they are leaking. I do a very comprehensive assessment to make sure it looks fine. If I don’t like it, no big deal, I can just open up the arms and release the leaflets and move my clipper to grab it again.
If I like how it looks, I can release the clip from the cable to which it’s attached and leave it behind.
I can put in as many as one to four clips in a particular patient in order to reduce that leak so the patient feels better. Their heart remodels and gets stronger. The blood pressure in their lungs comes down and they can hopefully regain their quality of life.