Our Summary

This research article primarily focuses on the evolution and importance of a specific treatment for a heart condition called mitral regurgitation. The treatment is known as transcatheter mitral valve repair (TMVr) and is performed using a device called the MitraClip.

In 2013, the U.S. Food and Drug Administration (FDA) approved the MitraClip device to treat primary mitral regurgitation, a condition where the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward in the heart. Then in 2018, a significant clinical trial led to the FDA extending approval in 2019 for the use of TMVr in patients with functional mitral regurgitation, a similar but distinct condition.

The study also highlights the vital role of a type of heart imaging called structural heart disease (SHD) imaging in identifying patients who could benefit from this treatment. This imaging technique also helps guide the procedure and monitor for any complications.

In simple terms, this paper reviews how TMVr with the MitraClip device has significantly improved the treatment of mitral regurgitation and how SHD imaging is an essential tool in this process.

FAQs

  1. What is the role of structural heart disease (SHD) imaging in managing mitral regurgitation?
  2. When was the MitraClip device by Abbott Vascular first approved by the FDA for the treatment of primary mitral regurgitation?
  3. What was the significant change in the management of mitral regurgitation following the landmark clinical trial in 2018?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve repair is to ensure they follow their post-procedure care instructions carefully, including taking medications as prescribed, attending follow-up appointments, and engaging in cardiac rehabilitation if recommended. It is important to communicate any new symptoms or concerns to their healthcare provider promptly to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for mitral valve repair include those with primary mitral regurgitation as well as those with functional mitral regurgitation. Primary mitral regurgitation refers to a structural abnormality of the mitral valve itself, such as mitral valve prolapse, while functional mitral regurgitation is caused by underlying heart conditions such as heart failure or coronary artery disease.

Recent landmark clinical trials have expanded the indications for transcatheter mitral valve repair (TMVr) with the MitraClip device to include both primary and functional mitral regurgitation. This has resulted in a paradigm shift in the management of patients with mitral regurgitation, with TMVr offering a less invasive treatment option compared to traditional open-heart surgery.

Patients who are candidates for TMVr undergo thorough evaluation, including imaging studies to assess the severity of mitral regurgitation and the suitability of the mitral valve for repair. Structural heart disease (SHD) imaging plays a crucial role in this evaluation process, providing valuable information to the heart team to ensure optimal outcomes for patients undergoing TMVr.

Overall, TMVr has revolutionized the management of mitral regurgitation and offers a promising treatment option for patients with both primary and functional mitral regurgitation.

Timeline

Before mitral valve repair:

  1. Patient presents with symptoms such as shortness of breath, fatigue, and palpitations.
  2. Patient undergoes diagnostic tests such as echocardiogram to determine the severity of mitral regurgitation.
  3. Patient is evaluated by a heart team to determine candidacy for mitral valve repair.
  4. Patient undergoes surgical or transcatheter mitral valve repair procedure.

After mitral valve repair:

  1. Patient may experience improvement in symptoms such as reduced shortness of breath and fatigue.
  2. Patient undergoes follow-up echocardiograms to assess the success of the mitral valve repair.
  3. Patient may be prescribed medication to manage any residual symptoms or complications.
  4. Patient continues regular follow-up appointments with their healthcare team to monitor their heart health and overall well-being.

What to Ask Your Doctor

  1. What is the underlying cause of my mitral valve regurgitation and how severe is it?
  2. What are the potential risks and benefits of undergoing mitral valve repair with the MitraClip device?
  3. Am I a suitable candidate for transcatheter mitral valve repair, or would traditional surgery be a better option for me?
  4. How many procedures have you performed and what is your success rate with mitral valve repair?
  5. What is the expected recovery time and long-term outlook following mitral valve repair?
  6. How will my mitral valve function be monitored and managed after the procedure?
  7. Are there any lifestyle changes or medications that I will need to consider post-procedure?
  8. What are the potential complications or risks associated with mitral valve repair that I should be aware of?
  9. Will I require any follow-up procedures or treatments in the future?
  10. How can I best prepare for the mitral valve repair procedure and what should I expect during the recovery process?

Reference

Authors: Beg F, Little SH, Faza NN. Journal: Curr Opin Cardiol. 2020 Sep;35(5):482-490. doi: 10.1097/HCO.0000000000000765. PMID: 32649354