Nonsurgical Repair of Mitral Valve

An early trial of a tiny metallic clip that is delivered and attached to the heart's mitral valve with a catheter shows that it may eliminate the need for open-heart surgery in some patients who suffer from mitral valve regurgitation (MR).

In chronic MR, blood leaks backward with each heartbeat, requiring the heart to work harder. Patients with significant mitral regurgitation eventually become so weakened by the condition that they require open-heart surgery with cardiopulmonary bypass. As many as 50,000 U.S. patients a year have open-heart mitral valve surgery.

The new procedure is performed in a cardiac catheterization laboratory, and requires two to four hours. Under general anesthesia, a catheter introduced through the skin in the thigh area is guided from the femoral vein to the affected area of the heart. The clip is precisely steered into place and attached to the mitral valve, helping it to close properly. Once the clip is securely attached, the catheter is removed. Echocardiography and fluoroscopy are used during the procedure.

Patients generally stay in the hospital one to two nights and return to normal activity within one week. To date, the clip has been used in 10 patients without complications. The clip was developed by Evalve, Inc. (Redwood City, CA, USA).

"This new clip is one of the interventional cardiology devices in the pipeline that will change the face of cardiology in the coming years,” said Ted Feldman, M.D., director of the Cardiac Catheterization Lab at Evanston Hospital, part of the Northwestern Healthcare System (Evanston, IL, USA; www.enh.org). "We are beginning to see an array of devices that are intended to repair or replace malfunctioning structures of the heart without surgical intervention.”






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