Mitral Valve Treatments and Options

There are two types of treatment for mitral regurgitation.

  1. Mitral valve replacement involves placing a new tissue or mechanical heart valve into the heart. This is predominantly performed through open heart surgery.
  2. Mitral valve repair involves fixing your own mitral valve that is part of your heart. This can be done either through open heart surgery or through a catheter-based technique that is less invasive.

Transcatheter MitraClip™ Procedures

Transcatheter edge-to-edge (TEER) mitral valve repair is a minimally invasive procedure that may be an option for patients who are too sick for open heart surgery. Unlike surgery, this procedure does not require opening the chest and temporarily stopping the heart.

The goal of placing a MitraClip™ device is to reduce mitral regurgitation so the valve continues to open and close more completely, thus restoring blood flow to circulate through your heart to the rest of your body as efficiently as possible.

The MitraClip™ procedure involves a catheter being inserted percutaneously (small puncture of your skin) whereby the physician will get access to your heart through a thin, hollow catheter that is guided through a vein in your leg near your groin up to your mitral valve. Because your physician will need you completely sedated, you will need general anesthesia during your procedure, and it may take up to two to three hours to complete the entire procedure.

The MitraClip™ device itself is a small clip less than the size of a dime coin, made of metal and covered with a polyester fabric. Santa Barbara Cottage Hospital cardiologists use the new MitraClip™ G4 system that allows your physician to determine the size of clip best suited to your heart’s anatomy.

Is TEER Using MitraClip™ Therapy the Best Option for Me?

To decide if this procedure is right for you, we need more information about you and your heart. After discussing your treatment options, a decision will be made jointly between you, your caregiver(s) and your doctor. To give us a complete picture of you and your health, you may need the following as determined by your Heart Valve Team:

  1. Evaluation by an International Cardiologist – A physician who is part of a specially-trained heart team that will review your medical history and perform a variety of tests to determine if you are a candidate for MitraClip™ therapy.
  2. Evaluation by a Cardiothoracic Surgeon - Another member of our specially-trained heart team who will evaluate your surgical risk. If you are considered a candidate, you will be referred to the Cardiac Services Program Coordinator for more testing.
  3. Evaluation by the Nurse Coordination/Liaison – The RN Coordinator/Liaison will contact you to ask a series of questions, complete a six-minute walk assessment and complete a questionnaire. They will be your best point of contact for updates as to the progress of your case throughout the workup and can be reached at (805) 324-9012.
  4. Transesophageal Echocardiogram (TEE) - A test that produces detailed pictures of your heart and heart valves using high-frequency sound waves (ultrasound). An ultrasound probe will be placed into your esophagus (through your mouth and down your throat) to more closely view your mitral valve. This test does require sedation so you will be asked to not eat or drink after midnight on the day of your test. You will also need to ensure you have a ride home from the hospital after this test is completed.
  5. Lab Work - A series of common blood tests to help identify possible problems that could complicate your procedure if not found and treated early.
  6. Coronary Artery Evaluation - A coronary artery evaluation may be recommended by your physician through either a stress test or a coronary angiogram. The latter requires taking pictures of the heart arteries with contrast, assessing for significant heart artery blockage and will require sedation so you will be asked to not eat or drink after midnight on the day of your test. You will also need to ensure you have a ride home from the hospital afterwards.

For your convenience, we will do our best to set up all your tests on the same one or two days when possible.

Depending on the results of these tests, further work up may be needed. Your Heart Team will discuss this plan with you and your caregivers.