Mitral and Tricuspid Transcatheter Edge-to-Edge Repair

Mitral and Tricuspid Transcatheter Edge-to-Edge Repair surgery, also known as MitraClip or TriClip procedure, is a minimally invasive technique used to treat mitral regurgitation (leaky mitral valve) or tricuspid regurgitation (leaky tricuspid valve). It involves the placement of a specialized device that clips together the leaflets of the mitral or tricuspid valve to reduce the backflow of blood and improve valve function.

 

Types

There are two main types of Transcatheter Edge-to-Edge Repair procedures:

  • MitraClip: This procedure is used to repair the mitral valve. The MitraClip device is a small metal clip attached to a catheter. It is inserted into a blood vessel and guided to the heart, where the clip is deployed to grasp and close the leaflets of the mitral valve.
  • TriClip: This procedure is used to repair the tricuspid valve. The TriClip device functions similarly to the MitraClip and is inserted and deployed in the tricuspid valve.

 

Treatments

Mitral and Tricuspid Transcatheter Edge-to-Edge Repair surgery is performed to treat mitral regurgitation and tricuspid regurgitation, which occur when the mitral or tricuspid valve fails to close properly, resulting in the backward flow of blood. This can lead to symptoms such as fatigue, shortness of breath, and fluid retention. The procedure aims to improve valve function, reduce symptoms, and improve quality of life in patients who are not candidates for traditional open-heart surgery or are at high surgical risk.

 

Before the procedure

Preparing for Mitral and Tricuspid Transcatheter Edge-to-Edge Repair surgery may involve:

  • Medical evaluation: Your healthcare team will perform a comprehensive evaluation to assess your overall health, including imaging tests and diagnostic procedures.
  • Medication management: You may be advised to adjust or stop certain medications before the procedure, as directed by your healthcare provider.
  • Fasting: You will be instructed to fast for a specified period before the procedure to ensure an empty stomach.

 

During the procedure

During Mitral and Tricuspid Transcatheter Edge-to-Edge Repair surgery:

  • Anesthesia: The procedure is typically performed under general anesthesia to ensure you are asleep and pain-free throughout.
  • Catheter insertion: A catheter is inserted into a blood vessel, usually in the groin, and guided to the heart using imaging techniques.
  • Placement of the clip device: The clip device is advanced through the catheter to the affected valve. Using real-time imaging, the clip is carefully positioned and deployed to clip together the leaflets of the mitral or tricuspid valve.
  • Evaluation and adjustment: The clip’s effectiveness is assessed, and additional clips may be placed if needed.
  • Removal of the catheter: Once the procedure is completed, the catheter is removed, and the insertion site is closed with sutures or other closure devices.

 

After the procedure

After Mitral and Tricuspid Transcatheter Edge-to-Edge Repair surgery:

  • Recovery: You will be closely monitored in a recovery area until you are stable. The length of hospital stay may vary, but it is typically shorter than with open-heart surgery.
  • Follow-up care: Regular follow-up appointments will be scheduled to monitor your progress, evaluate valve function, and make adjustments to medications if necessary.

 

Advantages

  • Minimally invasive: The procedure is minimally invasive, avoiding the need for open-heart surgery and its associated risks.
  • Reduced hospital stay: Compared to traditional surgical interventions, Transcatheter Edge-to-Edge Repair generally requires a shorter hospital stay and recovery period.
  • Improved symptoms: The procedure can significantly reduce symptoms such as shortness of breath, fatigue, and fluid retention, improving quality of life.

 

Risks

While Mitral and Tricuspid Transcatheter Edge-to-Edge Repair is considered a safe procedure, there are potential risks and complications, including:

  • Bleeding or hematoma at the catheter insertion site
  • Infection
  • Damage to blood vessels or heart structures during the procedure
  • Arrhythmias (abnormal heart rhythms)
  • Valve damage or dysfunction
  • Allergic reactions to anesthesia or contrast agents

 

Typical recovery time

The recovery period after Mitral and Tricuspid Transcatheter Edge-to-Edge Repair is typically shorter than that of open-heart surgery. Most patients can resume normal activities within a few days to weeks, depending on individual healing and the extent of the procedure.

 

Results

Mitral and Tricuspid Transcatheter Edge-to-Edge Repair can lead to significant improvements in valve function, reducing symptoms and improving quality of life. However, individual results may vary, and long-term follow-up is necessary to monitor valve function and durability.

Following the procedure, post-procedure care may include:

  • Regular follow-up appointments with the healthcare team to monitor the functioning of the artificial valve and overall cardiac health.
  • Medication adherence, including prescribed medications to prevent infection, manage blood pressure, and prevent blood clots.
  • Cardiac rehabilitation programs to gradually increase physical activity and improve cardiovascular fitness.
  • Close monitoring for any signs of valve dysfunction, abnormal symptoms, or complications, and promptly seeking medical attention if any concerns arise.