Percutaneous Mitral Valve Repair (Mitraclip) is a minimally invasive totally percutaneous aiming repair the Mitral Valve in cases of Mitral regurgitation. It’s a highly successful procedure (99,9%) extremely low risk( <1%) for the patient and targets patients mainly with Secondary Mitral regurgitation (MR), thus MR related to underlying heart dysfunction. Due to the high degree of specialisation and expertise required, it is a procedure available to a limited centers across Europe.
Heart Center team is certified for this procedure and and European experience having performed over 200 procedures and having been onvolved in the training of many hospitals across Europe.
Mitraclip procedure is a Safe, effective and durable procedure. The first procedure was performed in 2003. Ever since over 100000 procedures have been performed worldwide and have been exponentially growing ever since the FDA in the US has granted approval to use in practically every type of MR in March 2019.
According to the American study COAPT, mitraclip reduces death by 40% and hospitalization by 50% in patients with functional mitral regurgitation.
The complication rate is below 1%. The procedure has practically zero risk of bleeding since it is performed via the femoral vein, requires zero contrast media since it is echocardiography guided, and the patient is rapidly mobilized with Hospital discharge within 48 hours.
Which patients are suitable for Mitraclip
The patient’s that will mostly benefits from Mitraclip procedure are patients with functional regurgitation and heart failure. In these patients the valve is leaking due to an underlying condition such as previous heart attack, dilatation of the heart, cardiomyopathies.
These patients are commonly treated conservatively with medication since open heart surgery is extremely high risk and usually not effective and patients remain symptomatic with frequent recurrences of Mitral regurgitation. Even in young patients with functional mitral regurgitation mitraclip is currently the first line option due to its low risk and high efficiency.
This is another group of patients however that will benefit from mitraclip, and these are patients with primary, degenerative, anatomical MR, that are hiring for open surgery due to old age and other comorbidities. In this cohort, again mitraclip is preferable to open surgery due to the low risk of mortality and morbidity and the rapid rehabilitation of the patients.
How does mitraclip work
Mitraclip joins opposing leaflets together it’s the exact point where am I regurgitation takes place creating a tissue Bridge between the leaflets. This way by Bridging the Gap between the leaflets the anatomic deficit is either reduced or ameliorated completely and these reduces the degree of mitral regurgitation.
The clips are made of nitinol based alloy covered by PTFE polymeric witches biocompatible end is rapidly Incorporated and covered by the cardiac endothelium. Mitral clip is produced by a multinational company with great experience in manufacturing heart valves and other prosthetic materials.
The workflow of the procedure is simple. The patient is usually admitted at the same day of the procedure. The procedure is performed under conscious sedation and lasts between 30 minutes to 2 hours. Due to the percutaneous minimally-invasive nature of the procedure the heart never stops, the patient does not require extracorporeal circulation, and requires hospitalization for only about 48 hours.
Due to the fact that these patients commonly suffer from concomitant tricuspid regurgitation there have been cases that team treated simultaneously both mitral and tricuspid regurgitation at the same time using mitraclip. The results have been excellent with 100% success rate in all patients.