MitraClip is a small clip device placed via catheter as an alternative to open heart surgery for patients with moderate to severe mitral valve regurgitation. It is attached to the middle of the mitral valve leaflets to prevent blood from flowing backward. The procedure typically takes 1-2 hours and is performed under the guidance of transesophageal echocardiography (TEE) and fluoroscopy. The patient is either under general anesthesia or deep sedation.
What is MitraClip and How Does It Work?
MitraClip is a minimally invasive treatment method used in mitral valve regurgitation as an alternative to open heart surgery. By accessing the heart through a small incision in the groin, the valve leaflets are joined with a special clip to prevent blood from flowing backward. This method, which is especially preferred in patients with high risk for open heart surgery, provides a shorter recovery period.
The mitral valve is located between the left atrium and left ventricle of the heart and ensures one-way blood flow. When the valve does not function properly (mitral regurgitation), blood flows backward, and the heart has to work harder.
Who is MitraClip For? Is It Suitable for Every Patient?
MitraClip is generally suitable for patients with severe mitral valve regurgitation who are at high risk for open heart surgery. It is an ideal option especially for elderly patients, those whose general health condition cannot tolerate surgery, or individuals with other serious health problems. However, not every patient may be suitable for this treatment; therefore, a comprehensive evaluation is necessary.
How is MitraClip Treatment Performed?
MitraClip treatment is usually performed under local anesthesia in a catheterization laboratory. The cardiologist directs a catheter to the heart using a vein from the groin or neck. Through the catheter, the MitraClip device is advanced towards the mitral valve. The device brings the two edges of the valve closer together, preventing blood from flowing backward. During this procedure, the heart continues to pump blood in the body, so patients do not need general anesthesia.
The MitraClip procedure takes an average of 1-2 hours, and patients are monitored for several hours after the procedure. Patients usually stay in the hospital for one day and can return to their daily lives within a few days.
What Are the Advantages of MitraClip?
As MitraClip is a minimally invasive treatment method, it carries less risk compared to open heart surgery, and the recovery time is much shorter. The heart is not stopped during the procedure, and general anesthesia is not required, which is an important advantage especially for elderly and high-risk patients. MitraClip improves patients’ quality of life, alleviates heart failure symptoms, and provides a quick return to daily life.
- Minimally invasive: MitraClip does not require open heart surgery, which allows patients to recover faster. Incision marks are small, and patients feel less pain.
- Faster recovery: After MitraClip treatment, patients are discharged much sooner compared to open heart surgery and return to their daily activities more quickly.
- Reduced risks: Compared to open heart surgery, MitraClip is generally performed with lower risk. Complications such as anesthesia risk, infection, and bleeding are lower compared to surgery.
- Improving quality of life: MitraClip alleviates symptoms in patients with heart failure, increases exercise tolerance, and reduces problems such as breathing difficulties.
What Are the Risks of MitraClip?
While MitraClip is generally a safe method, it carries some risks as with any medical procedure. Conditions such as bleeding, infection, displacement of the device, or ineffectiveness may occur, albeit rarely. Additionally, inadequate closure of the valve or temporary heart rhythm disorders may occur during the procedure. These risks are related to the patient’s general health condition. When performed by experienced teams, risks are minimal.
- Bleeding: There may be a risk of bleeding during catheterization. It is generally minimal but may cause problems for some patients.
- Infection: There is a risk of infection in procedures performed via catheter.
- Displacement of the device: After the MitraClip device is placed, it may, although rarely, become displaced or ineffective.
- Inadequate mitral valve function: After the MitraClip device is placed, if the valve does not close tightly enough, leakage may continue.
- Arrhythmias: Heart rhythm disorders may develop during the MitraClip procedure, but this condition is usually temporary.
The benefits and risks of MitraClip are evaluated for each patient. The cardiologist has a detailed conversation with the patient about whether this treatment is appropriate.
Post-MitraClip Recovery and Follow-up
Patients stay in the hospital for a few days after MitraClip treatment. The recovery process is generally fast, but patients require regular check-ups for a certain period after treatment. These check-ups are performed to monitor the function of the device and the patient’s heart health. Additionally, patients receive guidance on lifestyle changes such as exercise and diet to support heart health.
MitraClip Frequently Asked Questions
Is the Heart Stopped During Heart Valve Surgery?
Yes, during traditional heart valve surgeries, the heart is usually stopped, and the patient is connected to a heart-lung machine. This device continues to provide blood and oxygen to the body during surgery. However, in minimally invasive methods like MitraClip, the heart is not stopped, and it continues to beat during the procedure.
How Long Does MitraClip Last?
The MitraClip device is designed to be long-lasting and generally provides a permanent solution. However, each patient’s situation is different, and the effectiveness of the device should be monitored with regular check-ups over time. Studies conducted so far show that MitraClip functions without problems for years.
Is Mitral Valve Regurgitation Dangerous?
Yes, mitral valve regurgitation is a serious condition. If left untreated, it can lead to heart failure, fluid accumulation in the lungs, rhythm disorders, and serious declines in quality of life. Especially severe mitral regurgitation can be life-threatening if proper treatment is not applied.
Can a Clip Be Attached to the Heart Valve?
Yes, during MitraClip treatment, a clip is attached to the mitral valve. With this method, the leaflets of the mitral valve are brought closer together, reducing or completely preventing blood from flowing backward (regurgitation). This procedure is a minimally invasive method and is applied as an alternative to open heart surgery.
What Are the Risks of MitraClip?
Rare risks include bleeding, infection, displacement or ineffectiveness of the clip, temporary rhythm disorders, and the continuation of partial leakage in the valve. Risks are evaluated on a patient-specific basis.
How Long Does the MitraClip Procedure Take?
The MitraClip procedure generally takes 1-2 hours. Since local anesthesia or mild sedation is used, the patient is taken to their room on the same day. The hospital stay is mostly between a few days.
How is the Recovery Process After MitraClip?
Most patients can return to daily activities within a few days. Complete recovery may take 2-4 weeks. Regular cardiology check-ups and lifestyle changes (balanced diet, light exercise) are recommended.
What is the Difference Between MitraClip and Open Surgery?
In open surgery, the heart is stopped, and the chest cavity is opened, while with MitraClip, the clip is placed via catheter. The recovery period is much shorter with MitraClip, and the risks are lower. However, surgery may offer a more permanent solution in some patients.
Is MitraClip Covered by SGK or Insurance?
In Turkey, MitraClip is covered by SGK for patients who meet certain criteria. Private insurance may also provide financing according to the policy coverage. It is recommended to consult with the institution and doctor for details.
Is Blood Thinner Used After MitraClip?
Although lifelong blood thinners are generally not required, medication use may continue depending on the patient’s accompanying conditions (such as atrial fibrillation). The treatment plan is personalized.
Conclusion
MitraClip is a revolutionary method in the treatment of mitral regurgitation. This minimally invasive procedure allows patients to improve their quality of life while being treated with a lower risk of complications. Although suitability varies for each patient, MitraClip offers an effective solution for many patients. With the advancement of technology, more patients will be able to benefit from this treatment and maintain heart health.
Reference: MitraClip
