When the valves or the leaflets of the mitral valve fail to close properly,blood flows back in to the left atrium during the cardiac cycle. As a result, the blood volume in the left ventricle is reduced,thereby an insufficient amount of blood is pumped throughout the body.To compensate this deficit, the heart increases the volume of the left ventricle to accomodate this increase in the blood it is pumping.In time the left ventricle undergoes a compensatory hypertrophy to meet the increased demand.In the primary stage there will be no symptoms,but as the regurgitation progresses,the left atrium enlarges,abnormal heart rhythms occur,and the hypertrophied left ventricle can no longer compensate the regurgitation.Over time the blood pressure in the pulmonary artery increases(pulmonary hypertension) and this eventually can lead to heart failure.
The diagnosis of the condition can be done by an ECG, a chest x-ray,and/or an echocardiogram.The treatment is surgical,either repair of the damaged valve or replacement of the valve should be done.The traditional method would require general anesthesia and the surgeon needs to perform a thoracotomy or sternotomy for repair or replacement of the valve.But a revolutionary method in valve repair has been discovered using the Evalve Mitraclip.The method is called percutaneous repair of the mitral valve using Mitraclip.This is a less invasive method compared to the traditional surgical methods.The results are also commendable.
- Less invasive
- Done on an beating heart without thoracotomy or sternotomy.So no need for any by-pass machine.
- Rapid recovery
The method involves suturing of the leaflets of the mitral valve together so that regurgitation into the left atrium is prevented.The valve continues to open through the sides of the suture and therefore blood continues to flow in to the left ventricle ensuring proper pumping of pure blood throughout the body.
The device has three parts:
1. A guide catheter
2. A clip delivery system
3. The MitraClip device(implant)
The guide catheter is inserted through the femoral vein at the groin and is guided into the mitral valve.The clip delivery system delivers and deploys the implant or device.The MitraClip holds and fastens the leaflets of the valve together. If needed a second clip is also used for better coaptation.After the clip is attached the catheters are removed.The procedure is done under general anesthesia.After a day or two the patient can leave the hospital.
LIMITATIONS OF THE DEVICE
1.If the regurgitation fails to get corrected, then surgical repair or replacement is the only option.
2.The large size of the catheter is a problem.
3.The whole procedure is technically damanding.
4.The long-term durability of the results of the device is unknown.
5.The device cannot be used in patients with severe pathology of the mitral valve.