Mitral valve repair may not require open heart surgery

Not all heart patients have to undergo open heart surgery. In fact, in 2009, interventional cardiologists developed a mitral valve clip as an alternative to having open heart surgery. Three years later, this procedure is used by many cardiologists but is still not the

About the Heart

Did you know that in about 20 seconds the heart pumps 5.6 liters of blood through yoru entire body? Your blood travels 12,000 miles a day and your heart beats 100,000 times. Your blood delivers oxygen and essential nutrients to your organs and body’s cells.

Why a Heart Attack Occurs

When the blood supply to the heart is cut off because of plaque build up, which caused narrowing of the arteries and restricted blood flow, or damage to the heart such as with the valves, a heart attack can occur. Symptoms of a heart attack include discomfort that feel like squeezing in the center of the chest, shortness of breath, pain or tingling in your left arm, sometimes a cold sweat, dizziness, and nausea.

Heart medication can target blockages a number of different ways. Nitrates will dilate the veins which decreases the heart’s oxygen needs, and they dilate the coronary arteries, which increases the blood flow to the heart. Beta blockers will decrease your heart rate and heart’s contractions. Aspirin or Plavex prevents platelets from clotting and causing blockages.

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.

Mitral Valve Regurgitation

Mitral valve regurgitation is a condition where the mitral valve of the heart doesn’t properly close, which allows blood to leak back into the heart.

One in five people over the age of 55 have a mitral valve problem, and this new alternative treatment might be an option rather than open heart surgery. Mitral regurgitation is a condition in which the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward into the heart. Shortness of breath is a common side effect of mitral valve problems.

“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.”

“Patients typically say they feel better,” Dr. Hanzel said. “They can breathe better. They can do more without having to stop and rest.”

Diagnosing Mitral Valve Prolapse

Mitral valve prolapse is usually diagnosed during a routine physical exam, when your doctor hears a click and a murmur as the valve leaflets bow back into left atrium with each heartbeat. The following tests are then often used to confirm the diagnosis:

  • Echocardiography
  • Transesophageal echocardiography
  • Cardiac Catheterization (cardiac cath or angiogram)
  • Radionuclide scans
  • Magnetic resonance imaging (MRI)

Mitral Valve Treatments

In some cases the alternative treatment to open heart surgery cannot be used because the damage is so severe that the valve must be replaced. The damaged mitral valve is replaced with an artificial valve that is either a mechanical valve or a tissue valve.

Mechanical valves are made of metal, and can last a long time. However, if you have a mechanical valve, you must take anticoagulant medication, such as Coumadin, for the rest of your life to prevent the formation of blood clots on the valve.

Tissue valves are made from animal tissue, usually as a pig’s heart valve. They can wear out over time and may need replacement. With the tissue valve you do not have to use long-term anticoagulant medication, which is an advantage.

Catheter Treatment of Mitral Valve Regurgitation

To alleviate mitral valve regurgitation cardiologist insert a catheter in the patient’s groin, through the femral artery, which then travels to the mitral valve. The catheter is used to feed the clip, where it eventually will grasp and tighten the valves’ leaflets. This stops the blood from leaking. The catheteris then removed but the clip remains in place.

The entire procedure takes no more than two hours and recovery is only a couple of weeks. This new alternative to open heart surgery is beneficial for heart patients with weak hearts where traditional surgery is dangerous, perhaps so much that the surgery cannot be conducted. The hope is the number of heart repairs that can be handled without open heart surgery will increase, using procedures similar to this. Robotics is the latest technology that is being developed to repair the heart.



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