Mitral Valve Clipping Surgery in India

India Cardiac Surgery Site is associated with experienced cardiologists to deliver the perfect treatment and recuperative plan. Before the surgery, we will educate the patient with every fact involved in surgery and maintain the transparency in procedure, facilities and the related costs. We provide quality services and also assist with arrangements by keeping the concerns of the international patients in mind, providing you the utmost care and professionalism.

How to Get Started?

Planning your medical trip to India is a very simple process with India Cardiac surgery site

1. You just need to fill in our enquiry form and one of our executives will contact you soon.
2. 91-9370586696 Call us at the given contact number for any assistance.
3. Complete information regarding surgery is provided in our website.
Click to Here Fill up our Enquiry Form

What is a mitral valve clip?

A mitral valve clip is a small metal clip, about the size of a large staple which is attached to your mitral valve via a vein in your leg. It repairs the damaged mitral valve without needing an open-heart surgery. This clip stays in the mitral valve permanently and helps the valve to function properly again.

Mitral clip was first implanted in 2003 and it became the FDA’s first commercially approved alternative to mitral valve regurgitation surgery in the year 2013. Mitral clips have been implanted as a new strategy to correct the motion of the mitral valve in selected patients with severe obstructive hypertrophic cardiomyopathy (HCM). Mitral clip has not yet established the long-term reliability of alcohol septal ablation or septal myectomy however the HCM specialists are increasingly offering the clip as a less-invasive treatment option.

Mitral clip was first implanted in 2003 and it became the FDA’s first commercially approved alternative to mitral valve regurgitation surgery in the year 2013. Mitral clips have been implanted as a new strategy to correct the motion of the mitral valve in selected patients with severe obstructive hypertrophic cardiomyopathy (HCM). Mitral clip has not yet established the long-term reliability of alcohol septal ablation or septal myectomy however the HCM specialists are increasingly offering the clip as a less-invasive treatment option.

Why do I need a mitral valve clip?

The heart has four main valves working like the gates or doors and allowing the blood to flow through the heart in one direction. The mitral valve is located between the heart’s two left chambers and it has two flaps or leaflets. These flaps or leaflets open and close thereby allow the blood to flow out of the top chamber to the bottom chamber.

The following shows the direction of blood through the heart valves:

If in case the mitral valve doesn’t close tightly enough then blood can flow backwards from the bottom chamber into the upper chamber and towards the lungs. This is known as mitral valve regurgitation which can sometimes lead to breathlessness, dizziness and tiredness. Some people may also experience swelling in legs and feet, called oedema. When left untreated the mitral valve regurgitation can lead to irregular heartbeat, chest pain or heart failure.

A mitral valve clip is a procedure which repairs the mitral valve. A miniature clip is attached to the abnormal part of the valve, closing it tightly, while the rest of the valve opens and closes normally. The effect of this is to prevent or minimise the amount of regurgitation through the valve.

This procedure is often recommended for patients who are too high risk for open-heart surgery. This is because open heart surgery is very invasive and not feasible option for all patients. Also the risk of complications and mortality increases greatly in patients with other health conditions such as previous chest surgeries, liver disease and age above 75 years which is why they are denied the surgery often.

The implantation of mitral clip via catheter doesn’t include the open heart surgery; however, it mimics the surgical method of the edge-to-edge valve repair. The mitral valve leaflets are then clipped together with the device instead of being sutured together thus, making it a much less invasive but still effective to improve the blood outflow of the heart.

Risks during a Mitral Valve Clipping Procedure

As with any surgery there are few risks during a mitral valve clip procedure. If the mitral regurgitation is not reduced then your symptoms might not improve.

Some of the risks include:

• Bleeding
• Vascular complications
• Lung complications
• Kidney failure
• Stroke, a condition where lack of blood flow to the brain causes rapid loss of brain function.
• Blood infection
• Gastrointestinal complications
• Septicemia, a serious infection of the blood caused by bacteria
• Death from this procedure is rare

Major vascular complications include hematoma- large blood clot under the skin or damage to the artery and the surrounding veins where the catheter was inserted needing surgical repair. Other risks include the longer use of a ventilator more than two days to help a patient breathe.

The doctor will explain the risks during a mitral valve clip procedure in detail. The patient should also discuss any questions or concerns with the medical team. The doctor will also ask you to sign a consent form to agree to the procedure.

How do I prepare for a mitral valve clipping procedure?

Preparation for the mitral valve clip procedure includes the following:

• Ask the doctor about taking your usual medications, especially if you are taking blood thinning medications or medications for diabetes.
• Do not eat for at least six hours before this procedure starts
• Do not drink any clear fluids and drinks such as water and tea without milk for two hours beforehand.
• Before the procedure starts, you will be asked to remove any jewellery and need to wear a hospital gown.

What happens during a mitral valve clipping procedure?

The mitral valve clipping procedure takes place in a catheter lab. Patient will be taken to the room and asked to lie on the procedure table. They will be awake throughout the procedure and the doctor will provide you medication which helps to relax.

During this procedure, your groin region is cleaned and you’ll be placed under general anesthetic or local anesthetic. A catheter containing the mitral clip is inserted into a leg vein in your groing. The fluoroscopy, an X-ray imaging helps the best doctor for mitral valve clipping surgery in India to guide the device through the venous system to the heart. Once at the heart, echocardiography or ultrasound imaging is used for positioning the device at the mitral valve. This device enters the heart through the inferior vena cava to the right atrium. Then the surgeon passes the catheter through the septal wall between the two atria thereby allow the device to pass to the left atrium.

This is a very precise puncture needing both the echocardiography and fluoroscopy images for locating the proper area. Then the mitral clip passes through the annulus into the left ventricle and sits below the leaflets. When on the ventricular side of the mitral valve, the mitral clip is opened and pulled towards the atria. The open mitral clip grabs both the mitral valve leaflets, the surgeon closes the clip and then the leaflets are clipped together. Fastening the clip to the leaflets reduces the regurgitant blood. When the clip is closed, the blood will continue flowing through the valve but not backwards towards the lungs.

Using both the fluoroscopy and echocardiography is necessary for performing the implantation of the mitral clip. But this needs the surgeon to mentally fuse the images from these two separate methods. There is a new technology called the EchoNavigator software which can merge the images from the fluoroscopy and echocardiography. It aims to reduce the procedure time and increase the success rates in the mitral clipping procedures. The integration of both the imaging techniques are especially valuable during the puncture of the atrial septum and while grasping the leaflets and fastening the mitral clip. These two steps are dependent on the surgeon having the precise placement in the heart and the EchoNavigator helps with placement. In cases needing multiple mitral clips to reduce the mitral regurgitation, the use of EchoNavigator can substantially reduce the procedure time.

What happens after a mitral valve clip procedure?

After the mitral valve clipping procedure, the doctor will monitor the patient closely and tell them how long they need to stay at the hospital. The team of medical professionals are dedicated to ensure the best possible outcome for the patient and they will also support recovery at every step of the way. Before going home, you’ll be given detailed instructions on how to recover well and return to good health. If you still continue feeling any signs or symptoms which are concerning you then make an appointment with the doctor.

Benefits of a mitral valve clipping surgery

The benefits of a mitral valve clipping surgery involves an immediate reduction of mitral regurgitation and a short hospital length of stay. Patients who were initially denied surgery may benefit with a mitral valve clipping surgery as it is successful in decreasing the mitral valve regurgitation, improving the emotional health, vitality and physical health as compared to the open heart surgery. Also the quality of life improves significantly in patients undergoing the mitral clipping procedure as compared to those who did not and are living with the mitral valve regurgitation. Patients experience significant improvement in the symptoms of the mitral regurgitation and quality of life soon after this procedure.

Further, the mitral valve clip provides an alternative to the surgical procedure and it is beneficial for patients for whom the mitral valve regurgitation is a detrimental condition which they were forced to live with. Patients who underwent the mitral valve clipping procedure continued experiencing improvement in their quality of life and were able to perform day to day tasks even after a year of the surgery. Also they have had fewer visits to the hospital for complications due to heart failure.

Warnings and Precautions

Remember these warnings:

A mitral valve clipping therapy should only be used in patients with significant, symptomatic, degenerative mitral regurgitation who are too sick for the mitral valve surgery. This therapy is intended to reduce the mitrl regurgitation and if the regurgitation isn’t enough then you may not get the full treatment benefits of reduced hospitalizations and improvements in the symptoms of heart failure and the quality of life.

The precautions include the following:

• The mitral clipping therapy should only be used in patients who are considered to be too sick for the surgery. This is determined by the clinical judgement of a heart team involving a cardiac surgeon who is experienced in the mitral valve surgery and a cardiologist who is experienced in the mitral alve disease based on the presence of one or more surgical risk factors.
• No benefit on how long a patient survives following the mitral clip therapy has been demonstrated. Also at this time, how long the mitral clip device will last is unknown.
• The first mitral clip device was implanted in the year 2003 and the laboratory testing supports durability of the device over a period of 15 years. Hence a regular medical follow-up is needed for evaluating how the mitral clip device performs. If you experience the return of any symptoms related to the mitral regurgitation then notify your doctor.
• Patients who have had this procedure should receive the prophylactic antibiotic therapy before any medical or dental procedure for minimizing the possibility of infection.
• The safety and effectiveness of the mitral clip procedure has been not yet established in patients with functional or secondary mitral regurgitation.
• This surgery has not been tested in pregnant women, children or infants and so it may not work for them.
  Also the safety and effectiveness of the mitral clip procedure have been not yet established in patients with specific mitral valve anatomy which interferes with proper placement and positioning of the mitral clip device. It includes:
  • A calcified mitral valve leaflets
  • A mitral valve opening which is too small
  • A leaflet flail width or leaflet flail gap which is too large
  • A cleft of the mitral valve leaflet