Cardiovascular system MitraClip

Mitral regurgitation is one of the leading causes of heart failure. The mitral valve is located inside the heart, between the left atrium and the left ventricle. It opens widely for the blood passage from the atrium to the ventricle and closes when the ventricle contracts to direct the blood flow to the aorta, and than to rest of the body. When the mitral valve does not close properly during left ventricular contraction it leaks and blood goes back into the left atrium, reducing the blood volume that is pumped to the aorta and the whole body. As time goes by if this leak is severe and is not treated there is gradual increase in heart size with blood and liquid accumulating in the lungs. Shortness of breath, fatigue and palpitations are the main symptoms. As the leak is mechanical in origin the solution is also mechanical, leaving little room for medications in severe leaks.

The most widely used treatment is valvuloplasty or replacement of the diseased valve by conventional surgery. In patients with advanced age or associated diseases, when conventional surgery carries high risk, transcatheter mitral valve repair with MitraClip is a recent and less invasive alternative.

The MitraClipR consists in a small clip that is delivered by catheter inserted through the femoral vein in the groin, avoiding cutdown. The clip delivery is guided by fluoroscopy and 3D echocardiography, grasps the two leaflets of the mitral valve, reducing the leak. It is a minimally invasive procedure.

This treatment can be used either in degenerative (primary) or functional (secondary to ischemic or dilated idiopathic cardiomyopathy).

Careful clinical evaluation and pre operative advanced imaging tests such as 3D echocardiography are essential to define which patient will benefit from this procedure.

Several transcatheter mitral prosthesis are being tested and soon will be available for clinical use.

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