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One in ten people over the age of 75 suffers from mitral regurgitation. Without the necessary treatment, this condition can lead to heart failure and pulmonary oedema, which can be lethal. The traditional method of mitral valve treatment is surgery. Unfortunately, for some groups of patients, surgery is more dangerous than the disease itself. In 2013 the FDA approved a new minimally invasive mitral valve treatment – MitraClip. It is suitable for patients who can’t have surgery. Learn about how MitraClip works and which clinics perform this procedure in this article.
What is mitral regurgitation
The human heart is divided into four chambers – two ventricles and two atria. Blood movement is ensured by four valves. Pulsating, they open and close, letting blood flow in the right direction. However, if the valve does not close completely, the blood will leak. This defect is called mitral regurgitation.
Due to disturbed blood flow, the body does not get enough oxygen, which causes constant fatigue and shortness of breath. The person’s blood pressure increases and the left atrium increases, which can cause several dangerous diseases: endocarditis, thromboembolism, pulmonary oedema, etc.
Mitral regurgitation can be acute and chronic, i.e. one that has been growing for many years.
Congenital defects or past diseases cause mitral regurgitation, for example:
Coronary heart disease;
Myocarditis;
Infectious endocarditis;
Rheumatic fever;
Congenital cleavage of the mitral valve;
Irradiation effects.
Mild mitral regurgitation usually does not require surgery as it is not dangerous and does not cause discomfort to the patient. Although. a patient should see a cardiologist every year to monitor the disease.
For severe mitral regurgitation, doctors perform plastic surgery or mitral valve replacement. Patients also take medication. However, drugs do not treat the cause of the disease, just ease the symptoms.
About 4% of all people suffer from mitral regurgitation. The risk groups are:
women;
people over 40;
underweight people;
people with kidney failure.
Symptoms and diagnosis of mitral regurgitation
Mitral regurgitation of early stages is almost asymptomatic because the heart compensates for the blood flow by enhancing atrial function. However, when the disease progresses to a mild or severe stage, the symptoms suddenly manifest:
shortness of breath during exercise;
tiredness;
swollen feet;
dizziness and fainting.
Based on the patient’s complaints, the doctor may suspect that the mitral valve is leaky. To confirm the diagnosis, he may prescribe:
Electrocardiography (ECG);
Chest X-ray;
Cardiac catheterization;
Stress-test.
If tests confirm mitral regurgitation, the doctor and the patient discuss the treatment prospects and the possibility of surgery.
How does the MitraClip procedure work?
The MitraClip looks like a coin-sized metal clip covered with a soft mesh. It is placed in the heart, beneath the mitral valve. If you look at the valve “from above”, it looks as if it was glued together in the middle, forming two holes. The MitraClip fixes the valve fabric and reduces leakage.
The MitraClip is designed for patients who can’t have open-heart surgery. Instead of large incisions, the surgeon injects the instrument through a catheter placed in the vein of the patient’s leg. This type of operation is called a transcatheter surgery. It reaches the heart by the vessels. Using ultrasound imaging, the doctor pulls up the valve flaps, normalizing the blood flow.
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MitraClip is made of chrome and cobalt mix with a polyester coating. These metals are non-toxic and safe for the body. The tissue grows around the device and therefore it remains where the surgeon has set it.
The operation is done under anaesthesia. On average it lasts 1-3 hours, depending on the complexity. As it is a minimally invasive procedure, the patient recovers more quickly than after open surgery. The patient will feel an improvement as soon as they wake up after the operation. Most people can be discharged from the hospital in 2-3 days.
The MitraClip has already helped more than 80,000 patients with mitral regurgitation.
MitraClip efficiency in mitral regurgitation
Before the invention of MitraClip, people with mitral regurgitation who couldn’t get surgery could only take medication. The disadvantage of this therapy is that it only hides symptoms, not eliminates their cause. Compared to drug therapy, MitraClip:
reduces the risk of heart failure by 73%;
reduces the number of hospitalizations by half;
increases life expectancy;
increases the quality of life.
Also, the MitraClip installation is more economically beneficial. The cost of the procedure is lower than the cost of regular hospitalizations with severe mitral regurgitation. Studies in the USA sample show that patients save about $35,000 in two years.
MitraClip procedure is safer than standard operation. There are no postoperative complications in 96.6% of cases.
Will the MitraClip procedure suit me?
To install the MitraClip, you need to have a check-up with a cardiac surgeon, who will confirm that you can have this procedure. Doctors take these factors into account:
Presence of primary mitral insufficiency of medium or high severity. This means that the failure was originally caused by a defect in the valve structure, not in other parts of the heart.
The patient is contraindicated to open-heart surgery. There are different scales of intervention risk assessment – EuroScore, Parsonnet, STS (Society of Thoracic Surgeons).
Cardiac evaluation and additional tests. Patient’s age, heart condition and general health are taken into account.
As with any surgery, there are risks and counter-indications. In particular, MitraClip is not performed on patients:
with infectious mitral valve inflammation;
with mitral valve rheumatism;
with blood clots;
with intolerance to medications that prevent blood clots.
Rehabilitation after MitraClip installation
After the MitraClip installation, the patient spends 2-3 days in the hospital. During this time, doctors monitor the patient’s condition and perform tests to make sure that the heart is functioning properly.
Restoration is quick and effective. At home, the patient will not need any additional assistance. For some time, the patient will need to take medication that prevents blood clotting.
Each patient who has undergone a MitraClip insertion will receive an implant ID card. Due to the metal in the device, it will activate airport security and metal-detecting procedures. The patient should have the card at all times so that the emergency doctors know they can’t use MRI.
Which clinics perform MitraClip procedure?
MitraClip is performed in large foreign clinics that specialize in transcatheter and minimally invasive cardiology.
| Turkey | In Turkey, you can contact the Medical Park Antalya Clinic and the Koç University Clinic. Doctors İsmail Ateş and Doruk Karayaslan have extensive experience with the MitraClip installation. One of the biggest advantages of cardiac surgery in Turkey is that European quality services are provided here at a lower price. |
| Poland | In Poland, the doctors at the American Heart of Poland Clinic, have the greatest experience in minimally invasive cardiac surgery. Doctors at this clinic quickly adopt the experience and technologies of their Western colleagues. Professors Andrzej Boheneck and Pavel Buchmann, who work at this clinic, have won numerous national and international awards. |
| Germany | Among German clinics, the most successful surgeries are performed at the Leipzig Helios Cardiology Center. Here, they specialize in minimally invasive and transcatheter procedures. In 2019, this clinic was voted the best in the country by Handelsblatt magazine. Some of the clinic’s best specialists are Dr Michael A. Borger and Andreas Bollmann. |
| Israel | In Israel, the MitraClip can be installed in the Ichilov clinic (Souraski). Professor Yaron Arbel specializes in this procedure. Ichilov Clinic cardiologists are regularly included in the FORBES’ “Top Doctors” list. |
| Spain | Among Spanish clinics, it is worth paying attention to the Quironsalud network. This hospital employs professors Giedrius and Aidetis Audrius, who are on the list of the best doctors in the country according to FORBES magazine. |
Resume
MitraClip is a new technology that allows treating mitral valve failure in patients who can’t have open surgery. It reduces the risk of heart failure by 73%.
MitraClip increases life expectancy and quality of life, reduces the number of hospitalizations.
MitraClip is a minimally invasive transcatheter procedure. It is safer than open surgery and patients recover faster after it. In 96.6% of cases, the procedure is performed without complications.
MitraClip can be performed in the best cardiology centres in Germany, Spain, Israel, Turkey and Poland.
If you are interested in MitraClip and you want to make an appointment for treatment, leave your request on our website by clicking “Get a free consultation”. Our coordinating physicians will contact you and help you choose a clinic and arrange treatment.
