The Mighty MitraClip

Using a minimally invasive procedure, doctors at Providence St. Joseph Hospital are able to strengthen a weakened heart valve, giving new life to patients.

It’s easy to assume that our hearts will keep beating perfectly throughout our lives. But for some people, a part of the heart called the mitral valve, which controls blood flow, can weaken. When this happens, a person might feel fatigue, heart palpitations, shortness of breath or no symptoms at all. The condition may first be detected when a doctor listening to a patient’s heart with a stethoscope hears a murmur.

Ideally, the two halves of the delicate mitral valve open wide then close tightly, again and again, allowing blood to continually pump from the upper heart chamber to the lower. But when the two halves of the valve, called leaflets, do not close completely, blood can leak back into the upper chamber, a condition known as mitral valve regurgitation. This strains the heart and reduces the amount of oxygen-rich blood being sent throughout the body. If it’s not treated, mitral valve regurgitation can lead to heart failure.

“Until recently, mitral valve disorder could only be treated by a skilled surgeon with valve repair or replacement, which requires an open-heart procedure, long hospital stay and long recovery,” says Maged F. Azer, MD, medical director of the Heart Failure Program at Providence St. Joseph Hospital.

A BIG STEP AHEAD
But today, patients at Providence St. Joseph have another, far less invasive option: the MitraClip procedure.

How does it work? Instead of opening a patient’s chest to operate on the heart, doctors make a very small incision in the patient’s vein near the hip, through which a tiny catheter or tube is inserted, explains Thomas C. Kim, MD, medical director of non-invasive cardiology at Providence
St. Joseph. A cardiologist guides a probe through the patient’s esophagus that produces an image of the mitral valve on a big screen nearby. At the same time, another cardiologist watches the screen as he guides the small MitraClip through a catheter to the patient’s heart and attaches it to the weakened mitral valve, bringing the two sides together. Sometimes it is necessary to attach two clips to the damaged valve.

Once in place, the clip prevents blood from leaking back into the upper chamber, explains Aidan R. Raney, MD, a cardiologist and comedical director of the Structural Heart Disease Program, who specializes in advanced interventional cardiology procedures at Providence St. Joseph.

The entire MitraClip procedure takes about an hour, and patients can usually go home after one night in the hospital. They can resume normal activities immediately, including walking, but must refrain from doing heavy lifting for a week or so.

“Most patients feel better right out of the gate,” says Dr. Kim. “In most cases, the benefits are immediate. Patients report that their leg swelling is better, the fatigue is better. It’s a pretty amazing procedure.”

SEVERAL ISSUES CAN CAUSE DAMAGE
What causes mitral valve regurgitation? Simply getting older can result in the mitral valve getting weaker, but it can also become damaged when a person has rheumatic fever, an infection of the heart’s lining, a heart attack or a heart defect. Because it is minimally invasive, the MitraClip procedure is a tremendous benefit for some older people and other patients who are not able to undergo open-heart surgery.

Doctors at Providence St. Joseph perform more MitraClip procedures than any other hospital in
Orange County, and the hospital is ranked among the top 25 in the nation in volume of procedures. “St. Joseph has developed an advanced structural heart program with a multidisciplinary team evaluating patients with a variety of valve diseases and performing many procedures repairing this complex valve without the need for open-heart surgery, thus providing hope for patients who are high surgical risk,” Dr. Azer says.

This procedure is relatively new—“just ten years old from its investigative beginnings,” says Brian Kolski, MD, co-medical director of the Structural Heart Disease Program at Providence St. Joseph—but it has been shown to improve and extend the lives of patients. Because of this procedure, “not only do patients feel better, they are hospitalized less, and survival is much increased,” says Dr. Kolski.

For more information or questions about our cardiac program, call 844-925-0945.

Previous Article
Skin Cancer Prevention: Q&A: An Ounce of Prevention...
Skin Cancer Prevention: Q&A: An Ounce of Prevention...

We caught up with Trevan Fischer, MD, surgical oncologist at the Center for Cancer Prevention and Treatment...

Next Article
Planning for a Baby?
Planning for a Baby?

Choosing who will deliver your baby—and where—is a big decision. Providence St. Joseph Hospital and its hig...