Mitraclip - (Non-Surgical Mitral Valve Regurgitation Repair)
Mitral valve regurgitation is a condition where the mitral valve, located between the two chambers on the left side of the heart, does not close completely. This causes blood to leak backward and leads to the heart working harder over time. Consequently, symptoms that reduce quality of life, such as shortness of breath, easy fatigue, and palpitations, may occur. Mitraclip is an alternative developed especially for patients who carry a high risk for open-heart surgery.
What is Mitraclip Non-Surgical Mitral Valve Regurgitation Repair?
Mitraclip is an innovative approach for the treatment of mitral valve regurgitation without the need for surgical intervention. Mitraclip is a minimally invasive treatment method that aims to correct the function of the mitral valve without opening the chest, meaning without the need for major surgical procedures. The procedure is usually performed by accessing the heart via a catheter through the groin area. During the application, the leaflets of the mitral valve are brought together with a tiny clip, thereby reducing the backward leakage of blood. This clip is made of a durable material that is compatible with the heart's own structure.
In Which Diseases is Mitraclip Used?
Mitraclip is a method primarily used in the treatment of mitral valve regurgitation that is applied without the need for surgery. In some patients, the problem is directly in the valve itself, which is called "primary mitral regurgitation." Mitraclip becomes an important option, especially in this group of patients who carry surgical risk. In some individuals, the valve cannot close completely because the heart is enlarged or weakened. This is called "secondary mitral regurgitation." Mitral valve regurgitation, which can start with mild symptoms, can progress over time to more serious clinical conditions. In these cases, which usually develop due to advanced heart failure, Mitraclip may be preferred to reduce the heart's workload and alleviate the patient's symptoms that affect daily life, such as shortness of breath. When evaluated clinically, grade 3 mitral valve regurgitation is considered an advanced condition that may require intervention. For individuals for whom surgical intervention is risky due to factors such as old age, diabetes, kidney failure, or previous heart surgeries, Mitraclip offers a safe and effective alternative.
What Are the Symptoms?
The mitral valve, located between the left atrium and the left ventricle of the heart, ensures that blood flows in the right direction with every heartbeat, but when this valve does not close completely, blood leaks back into the heart. This causes the heart to work harder and eventually become fatigued. Symptoms of mitral valve regurgitation include:
Shortness of breath,
Easy fatigue and weakness,
Palpitations,
Swelling (edema) in the legs and feet,
Frequent urination at night,
Dry cough.
How is it Diagnosed?
The diagnosis of mitral valve regurgitation cannot be made solely by looking at symptoms because this disease can remain silent for a long time or manifest itself with complaints that can be confused with other problems such as fatigue and shortness of breath. Therefore, an accurate diagnosis is only possible through a detailed cardiological evaluation and imaging methods. The diagnostic process usually begins with the doctor taking a detailed medical history from the patient. The physician asks how long the complaints have been continuing, under what conditions they increase, and the patient's past illnesses. Then, the heart is listened to with a stethoscope. In mitral valve regurgitation, a typical "murmur" sound can be heard in the heart. This sound is caused by the blood leaking back in the heart and is one of the first clues for diagnosis. This initial impression is not sufficient for a diagnosis. The real determinant is the heart ultrasound, which allows for detailed imaging of the heart. In some cases, transesophageal echocardiography performed through the esophagus is preferred to obtain a clearer image. Additionally, an ECG may be requested to evaluate the heart's rhythm, and a chest X-ray may be requested to see heart enlargement or fluid accumulation in the lungs. When necessary, blood tests or heart angiography to evaluate the coronary vessels may accompany the diagnosis.
How is Mitraclip (Non-Surgical Mitral Valve Regurgitation Repair) Performed?
Mitraclip is a method developed as an alternative to surgery in the treatment of mitral valve regurgitation, applied without stopping the heart and without opening the rib cage. The goal of this procedure is to correct the structure of the leaking mitral valve with the help of a small clip. During the application, the heart's functioning is not interrupted. This offers a great advantage, especially for patients who are elderly or at high risk for heart surgery.
The procedure is usually performed under general anesthesia. The patient is put to sleep and feels nothing. The Mitraclip device is guided with the help of a catheter that reaches the heart by entering through the large vein in the groin area. This catheter is a thin, flexible tube, and at its tip, there is both the system carrying the clip and imaging support. The catheter passes from the right side of the heart to the left atrium and reaches the point where the mitral valve is located. At this stage, the procedure is monitored in real-time using a special ultrasound method called transesophageal echocardiography.
When the Mitraclip device reaches the mitral valve, the clip is placed to join the two leaflets of the valve from the middle. In this way, the valve closes more properly, and the backward leakage of blood is significantly reduced. After the placement of the clip is completed, the doctor performs final checks and, after ensuring that everything is in order, removes the catheter. The entry point in the groin area is closed with a small dressing.
The recovery process after the procedure is quite comfortable. Patients can often stand up the next day, return home within a few days, and return to their daily lives in a short time. Compared to mitral valve surgery, this is a very comfortable process.
Frequently Asked Questions
For Mitraclip to be applied, the patient must first have moderate to severe mitral valve regurgitation. This regurgitation can be primary (i.e., structural defect of the valve) or secondary (functional due to enlargement of the heart muscle). The most important issue here is that the valve structure is at a level that can be repaired with the Mitraclip device. If the valve is too calcified, torn, or structurally damaged in ways that are not suitable for holding a clip, the procedure may not provide benefit. At the same time, the patient's general health status is also taken into consideration. Especially if conditions such as advanced age, heart failure, kidney failure, lung diseases, or having had heart surgery before make the patient risky for open-heart surgery, Mitraclip stands out as a safe alternative for these patients. Mitraclip is not applied to everyone. The procedure can only be performed on patients who meet certain criteria. For example, open surgery is usually preferred in young patients who have mild mitral valve regurgitation, are in good general condition, and have no obstacles to surgery. Mitraclip is evaluated especially for patients who are not suitable for surgical intervention or who do not want surgery. Also, in some patients, the structure of the mitral valve may not be suitable for attaching a clip. In such cases, it is not applied because an effective result cannot be obtained even if the procedure is performed. The first step begins with a detailed transthoracic echocardiography (TTE). With this method, the structure, mobility, and degree of leakage of the mitral valve are observed much more clearly. In addition to this, heart rhythm is evaluated with ECG, and a chest X-ray and, if necessary, pulmonary function tests are performed. Blood tests, kidney functions, and cardiac enzymes are also examined to evaluate the heart's general function and its effect on the body. In some cases, angiography may also be required to rule out coronary artery disease. The biggest advantage of Mitraclip is that it can be applied without opening the chest, that is, without the need for open-heart surgery. This provides great comfort and safety, especially for patients who are elderly, have accompanying diseases, or have had heart surgery before. Also, since the heart is not stopped during the procedure, it can be safely applied even in patients with weak heart functions. Thanks to Mitraclip, complaints such as shortness of breath, easy fatigue, and palpitations are significantly reduced. Mitraclip can be successfully applied by experienced teams only in certain heart centers across Turkey. Mitral valve repair performed with the Mitraclip method is an extremely safe procedure when applied to the right patient and by an experienced team. Being much less invasive than open-heart surgery provides a serious advantage for people with poor general health. Moreover, in this method, the heart is not stopped, the chest is not opened, and the recovery process is quite short. There is no clear age limit for the Mitraclip procedure. Being young or old is not a sole determinant. The main important thing is whether the patient's heart valve structure is suitable for Mitraclip and whether their general health status is at a level that can handle this procedure. As with any medical procedure, there are certain risks in Mitraclip. Among the most common are bleeding in the groin vessel, the development of arrhythmia within the heart, or the device not sitting exactly in the desired position. In rare cases, a second procedure may be required as a result of the clip being insufficient or loosening. During Mitraclip, the patient is mostly under general anesthesia, meaning they sleep throughout the procedure and do not feel anything. After the procedure, pain is also much less compared to major surgeries. There may be a small sensitivity at the entry point in the groin area, but this situation passes in a short time and is not at a level that will affect daily life. The Mitraclip method usually lasts between 2 and 4 hours, but this duration varies depending on the patient's heart structure, the degree of leakage in the valve, and whether an additional clip is needed during the procedure. After the procedure, it is usually necessary to stay in the hospital for one or two nights. During this time, the patient's condition is observed, vital signs are followed, and precautions are taken against possible complications. While this period can reach a week in open-heart surgery, this period is quite short in Mitraclip. Most patients return home a few days after the procedure and adapt quickly to their daily lives. Mitraclip shows its true benefit when applied at the right time in the right patient profile, not in every mitral regurgitation. Hospitals that apply the Mitraclip method offer an important treatment option for patients looking for an alternative to open-heart surgery. Advanced cardiological procedures like Mitraclip are not a standard treatment that can be applied in every health institution because this method can only be safely performed in centers with a strong technical infrastructure, an experienced heart team, and special equipment. We carry the responsibility and privilege of being one of the few heart centers in our country in this field.
If you have shortness of breath, easy fatigue, or a diagnosis of mitral valve regurgitation, consult our Cardiology specialists to learn the most suitable treatment option for you. Let us determine whether the Mitraclip method is suitable for you with a detailed evaluation.
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