January 1, 2009 — Interventional cardiologists created an alternative to open heart surgery by developing a mitral valve clip. To alleviate mitral valve regurgitation--a condition where the heart's mitral valve does not close properly, allowing blood to leak back into the heart--cardiologists insert a catheter into the patient's groin that travels up into the mitral valve. The clip is fed through this catheter, where it finally grasps and tightens the valves' leaflets--effectively preventing blood from leaking. The clip remains in place while the catheter is removed, the entire procedure taking approximately two hours and recovery a few weeks. The procedure is good for those with weaker hearts, when traditional surgery is more dangerous.
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Chances are you know someone who has had heart problems. In fact, one in five people over the age of 55 has a problem with their mitral valve. A new alternative to open heart surgery can get their blood flowing again.
Nothing keeps 77-year-old Josephine Herndon from shopping, but her hobby was slowed down by a heart problem called mitral regurgitation.
"In the store, I sat down, and I was breathing pretty heavily," said Herndon. "I could barely make it back to the car."
Mitral regurgitation is a condition in which the heart's mitral valve doesn't close tightly, allowing blood to flow backward into the heart.
"I had a leaky valve and didn't even know it," Herndon said.
"A lot of these patients have shortness of breath," said George Hanzel, M.D., an interventional cardiologist at William Beaumont Hospital in Royal Oak, Mich. "The main thing they have is fatigue, exercise intolerance, shortness of breath and swelling."
Herndon was one of the first patients in the United States to have the mitral clip procedure. First, interventional cardiologists inserted a catheter into her groin up into the mitral valve. Next, a clip was fed through. The clip grasped and tightened the valves' leaflets, preventing blood from leaking.
"By pulling them together and approximating them, it reduces the leakiness," Dr. Hanzel said.
The clip stays and keeps blood from leaking, and the catheter is removed. The procedure takes two hours, the same as for open-heart surgery. The difference is in the recovery -- down from months to just weeks.
"Patients typically say they feel better," Dr. Hanzel said. "They can breathe better. They can do more without having to stop and rest."
Herndon's mitral regurgitation was reduced from severe to trivial, and she's back looking for bargains again. "I always did love to go shopping," Herdon said.
The mitral clip procedure is good for patients who have a weak heart and may not make it through traditional surgery. The procedure is being investigated in clinical trials in 38 hospitals across the country.
ABOUT MITRA CLIP: The Mitra Clip is a device inserted into the heart by a catheter. It is used to gather and fasten the leaflets of the mitral valve of the heart, which can become loose enough to allow blood to leak when the valve is closed. Doctors insert the catheter into the femoral artery, and then work it through the body to the heart. Using this technique can help patients recover more quickly from mitral valve repairs.
HAVE A HEART: The heart pumps 5.6 liters of blood through the entire body in roughly 20 seconds; each day your blood travels some 12,000 miles, and your heart beats about 100,000 times. This delivers oxygen and other essential nutrients to the body's cells and organs. A heart attack occurs when the blood supply to the heart muscle is cut off, either because part of the heart is damaged (such as the valves to the chambers), or because plaque has built up inside the arteries, narrowing them and severely restricting blood flow. Symptoms of a heart attack include a squeezing discomfort in the center of the chest, pain or tingling in the left arm, shortness of breath and sometimes a cold sweat, nausea, or dizziness.
ABOUT HEART DISEASE: Most heart diseases arise from hardening of the arteries, especially from the buildup of fatty material along the inner lining of the arteries. Coronary arteries supply blood to the heart. When a blockage occurs, this flow is decreased. Heart medications target these blockages in several different ways. Nitrates dilate the veins, decreasing the oxygen requirements of the heart. They also dilate the coronary arteries to increase blood flow to the heart. Beta-blockers decrease the heart rate and the force of the heart's contractions. Aspirin prevents platelets in the blood from clotting and clumping on blood vessel walls.
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