Fixing the Leak

Open-heart surgery is the standard method for repairing mitral valves, but for some, a treatment option now available at Roper St. Francis Healthcare may be a safer alternative

Written By Hailey Middlebrook

Our hearts work incredibly hard. Every day, the average adult human heart pumps nearly 2,000 gallons of blood, which is circulated throughout the body to allow our organs and tissues to function. Typically, oxygenated blood is pumped from the lungs to the body by the left side of the heart. Meanwhile, oxygen-depleted blood is pumped from the body to the lungs by the right side of the heart. But in people with a heart condition called mitral valve regurgitation, that pumping system doesn’t work properly, which can cause serious issues.

Dr. Matthew O’Steen

Mitral regurgitation is a type of valvular heart disease that occurs when the mitral valve (which is located between the upper and lower left heart chambers) doesn’t close tightly enough, allowing blood back into the lungs instead of moving it forward into the body. While cases of mild mitral valve regurgitation are not problematic, moderate to severe cases often require open-heart surgery to replace or restore function of the valve. In January 2020, Roper St. Francis Healthcare began offering a minimally invasive alternative to surgery: the MitraClip procedure, which offers transcatheter mitral valve repair without any major incisions, drastically decreasing recovery times. “People who are vulnerable to postoperative complications can really benefit from this treatment,” explains Roper St. Francis Healthcare affiliated cardiologist Matthew O’Steen.

HC: What are the symptoms of mitral valve regurgitation?
MO: People with mitral regurgitation often have heart murmurs and experience irregular heartbeats, excess fluid in the lungs, swelling in the legs and shortness of breath when walking or lying down. A heart murmur—which a primary care doctor can detect with a stethoscope during a checkup—is often the first indicator for the disease because many patients are otherwise asymptomatic.

HC: Who does this condition typically affect and are there any risk factors associated with it?
MO: We see it most frequently in the elderly but can see it in patients at any age, including those in their 20s and 30s. Factors that increase one’s risk for mitral regurgitation include other heart-related issues such as mitral valve prolapse, rheumatic heart disease caused by untreated streptococcus infections like strep throat, coronary artery disease, degeneration of the mitral valve due to aging and endocarditis (or infection of the mitral valve). If left untreated, mitral regurgitation can weaken the heart and lead to congestive heart failure.

The MitraClip can be inserted via catheter to plug a leak in the heart’s mitral valve.

HC: What is the standard treatment for mitral regurgitation?
MO: For moderate to severe cases, open-heart surgery has traditionally been the go-to treatment. During this surgery, patients are put under anesthesia and hooked up to a heart-lung bypass machine, which keeps blood circulating while we open the chest and patch up the valve. The operation usually takes several hours and the patient stays in the hospital for five to seven days afterward to recover.

HC: How is the MitraClip procedure different?
MO: The MitraClip procedure doesn’t require open-heart surgery, which minimizes a person’s risk of developing postoperative complications and speeds up recovery time. During this procedure, the patient is put under anesthesia and we insert a catheter with a clip into the femoral vein at the groin. We then use the clip to close the leak in the valve. The patient can go home and resume regular activities the next day. This treatment is extremely beneficial for people who are at higher risk for complications during or after traditional surgery, including those with weak hearts or who have other chronic health conditions.

Photographs (Dr. O’Steen) courtesy of the doctor; (Mitraclip) courtesy of Abbott; & (heart) by shutterstock/CLIPAREA l Custom media