Transcatheter Mitral Valve Replacement (MitraClip)

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The goal of MitraClip treatment is to decrease mitral regurgitation (MR) and improve the patient's quality of life. MitraClip is only applicable to a limited group of patients with a certain heart anatomy and specific type of mitral regurgitation. 

The current standard of care for treating severe MR is to perform open heart surgery and either replace the mitral valve with an artificial valve (mitral valve replacement) or fix the native valve (mitral valve repair). 

Open heart surgery is the most effective method of treating severe mitral regurgitation. However, not all patients are candidates for open heart surgery. The MitraClip procedure is a minimally invasive, catheter-based treatment that presents an alternative for patients who are not eligible for open heart surgery due to higher risk. Transesophageal echocardiogram (TEE) will provide the surgical team with specific measurements of the patient's mitral valve.

The Mitraclip Procedure

1. The patient is first put to sleep (using general anesthesia). 

2. The surgeon makes an incision in the patient's groin to access the femoral vein, through which they will insert a catheter (hollow tube).

3. The MitraClip is inserted via the catheter and is guided through the aorta to the right chambers of the heart.

4. A tool on the tip of the catheter is used to puncture through the wall separating the left and right atria (upper chambers) to reach the left side of the heart where the mitral valve is located. This is done by using advance imaging techniques to guide the tool. 

5. The MitraClip is then inserted through the catheter and positioned at the site of regurgitation. It is not uncommon to use two MitraClips to repair a leak. 

6. The clip (or clips) are attached to the mitral valve leaflets to reduce the amount of blood that leaks backwards in the heart. 

7. The patient remains in the hospital for one day to one week, depending on the current status of their health.

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