• MitraClip and Treating the Mitral Valve

    The MitraClip, shown here, is a device that can be used to treat some patients who have a leaky mitral valve. Because the procedure is less invasive than open-heart surgery, it may be an option for patients who are too frail or sick for surgery. (Photograph provided courtesy of Abbott.)
    Researchers are exploring less-invasive, catheter-based approaches for repairing the mitral valve. One innovative, less-invasive procedure for heart valve repair, the MitraClip, is now an option for people who need improvement in leakage of the mitral valve.

    How the MitraClip Works

    The MitraClip is a tiny clip that grasps the two leaflets of the mitral valve to create two smaller openings, rather than one large opening. This reduces blood from flowing backward (regurgitating). The clip is placed in the heart using a slender tube called a catheter. The catheter is threaded up to the heart through a vein in the groin. The clip is then moved into position directly over the center of the mitral valve's leaflets using ultrasound guidance. Then the catheter is removed from the patient's body, leaving the clip behind.

    Benefits of the MitraClip

    According to the data from clinical trials, using the MitraClip is promising for treating severe mitral valve regurgitation in patients who were too sick for surgery. Data from a clinical research study called the Endovascular Valve Edge-to-edge REpair STudy (EVEREST II) High Risk Registry found that after one year, patients who underwent the experimental procedure had a survival rate of 75 percent versus a survival rate of 55 percent for patients who received medication only. Additionally, 74 percent of survivors after a year had no or only slight limitations on physical activity.

    MitraClip Approved by the FDA

    In October 2013, the United States Food and Drug Administration (FDA) approved the MitraClip device for use in patients outside of research trials. This green light from the FDA is potentially very good news for patients who have severe symptoms but are not good candidates for open-heart surgery to repair or replace their valve. MitraClip can give these patients a shot at feeling better and living longer.

    Other Devices in the Pipeline

    Another catheter-based approach delivers a device via catheter to change the size and shape of the ring of tissue that circles around the valve (mitral annulus). Like cinching a belt, the mitral annulus is tightened so the mitral flaps will close properly. This is called an annuloplasty. One study is testing the safety and effectiveness of planting a spring-type device in the coronary sinus, which runs behind the mitral valve, as a way to alter the shape and size of the annulus and encourage the valve leaflets to close properly. This device and others are still under investigation and are not yet approved by the FDA.

    With technology so rapidly changing the treatment options for patients with heart valve problems, it is more important than ever to discuss your options with your doctor.