MitraClip is a breakthrough therapy using a catheter delivered through the skin that significantly improves symptoms, disease progression and quality of life for people with mitral regurgitation who are at prohibitive risk for an invasive procedure. The only way to repair mitral valves previously was through open-heart surgery, but the presence of multiple health conditions, frailty or advanced age left many patients with mitral regurgitation — the backflow of blood into the heart due to a faulty mitral valve — without effective treatment options.
MitraClip received approval by the Food and Drug Administration in 2013. It remains the only effective treatment for patients with mitral-valve disease who are not good candidates for traditional surgery.
Healthy valves function as one-way gates that keep blood moving forward through the heart. Mitral regurgitation is the most common type of heart-valve insufficiency. It occurs when the leaflets of the mitral valve do not close completely, allowing blood to leak back from the main pumping chamber into the lung circuit. As a result, the heart works harder to provide adequate blood flow to the body and the backup of blood into the lungs causes breathing difficulty.
Mitral valve regurgitation can be a debilitating, progressive and life-threatening disease that damages the cardiac muscle and raises the risk of arrhythmia, stroke and heart failure. Symptoms include shortness of breath, extreme fatigue, lightheadedness, foot and leg swelling and palpitations. Medications are limited to symptom management and do not stop the progression of the disease.
The MitraClip procedure takes about two hours and is performed under general anesthesia. A typical hospital stay is about three days. Symptoms can improve immediately due to increased circulation efficiency.
The MitraClip, aided by state-of-the-art cardiac imaging, is delivered via catheter to the patient’s heart and mitral valve through the femoral vein. Once positioned and implanted, the tiny clothespin-like device works by permanently clipping together a portion of the leaflets of the valve. The backflow of blood is reduced or eliminated, allowing the heart to pump more efficiently.
Multiple clinical trials, published reports and registries of patients treated with the MitraClip have demonstrated a positive safety profile, reduction in mitral regurgitation, improvement in symptoms and quality of life and decrease in hospitalizations for heart failure, even in some of the most ill and debilitated patients. Analysis of a 2013-2014 nationwide mitral regurgitation registry involving 564 patients showed the MitraClip success rate (defined as a reduction in regurgitation to a level of “moderate” or less) to be 91.8 percent.
UCLA’s dedicated mitral-valve team works in close partnership with patients, their families and referring physicians to coordinate a care plan designed to offer the best outcomes. A bi-monthly conference allows access to the entire mitral-valve team in one visit and location. Individuals are encouraged to ask questions and a detailed review of each patient’s clinical prognosis and personal preferences is discussed. The team offers a same-day consensus and joint recommendation for the most effective treatment strategy.
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UCLA Cardiovascular Center
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Los Angeles, CA 90095