Minimally invasive treatment for a leaky mitral valve reduces heart failure symptoms without surgery

Transcatheter mitral valve repair treats mitral regurgitation.

A minimally invasive mitral regurgitation treatment to repair the mitral valve is now available, giving a new option to patients who may not be able to tolerate conventional open heart surgery to fix the valve.

Mitral valve regurgitation sometimes doesn’t need any treatment or can be treated with medication. In moderate to severe cases the valve needs repair to make it close tighter and prevent blood from squirting backward in the heart.

“Heart surgery is still the recommended treatment for patients with moderate to severe mitral valve regurgitation or those with severe valvular disease,” said D. Sean Stewart, M.D., medical director of interventional cardiology at Norton Heart & Vascular Institute and medical director of the Norton Heart & Vascular Institute Structural Heart Program. “Patients who haven’t found relief from other treatments and are too sick to undergo surgery are benefitting from this new option.”

Interventional cardiologists at Norton Heart & Vascular Institute have been helping patients with this minimally invasive mitral valve repair for more than two years.

The mitral valve controls blood from your lungs flowing into the left ventricle. If it doesn’t close properly, blood can get pumped back into the left atrium when the powerful left ventricle squeezes blood into the aorta and on its way through the body.

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This backup of blood, also called regurgitation because it’s flowing the wrong way, can be severe enough to cause symptoms such as fatigue and feeling out of breath. If it isn’t treated, mitral valve regurgitation can lead to heart failure or heart rhythm conditions.

Transcatheter mitral valve repair (TMVr)

Norton Heart & Vascular Institute interventional cardiologists can repair the mitral valve by threading a thin catheter through blood vessels. The procedure is known as transcatheter mitral valve repair (TMVr). At the site of the mitral valve, a tool on the end of the catheter places a clip, MitraClip, on the two mitral valve leaflets. Since the heart is still beating, interventional cardiologists assess how well the clip is working and can adjust its position until the regurgitation is minimized if not eliminated.

TMVr versus TMVR

Although they sound very similar, transcatheter mitral valve repair (TMVr) is very different from transcatheter mitral valve replacement (TMVR). The TMVR valve replacement procedure places a new valve in place of a previously implanted bioprosthetic valve made of tissue that has started to wear out.

Replacement valves made from animal tissue can last up to 20 years. Over time, the tissue valve wears out and patients can start to experience regurgitation or a narrowing of the valve — stenosis — that similarly limits blood flow.

Open heart surgery to replace the valve isn’t an option for some patients, and TMVR, also known as a valve-in-valve replacement, performed by a Norton Heart & Vascular Institute cardiothoracic surgeon or interventional cardiologist, can improve quality of life dramatically.

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