Transcatheter Mitral Valve Repair (TMVr)

TMVr is mainly used to treat mitral regurgitation (leaking mitral valve), which causes:

• Shortness of breath
• Fatigue
• Swelling in legs or ankles
• Irregular heartbeat
• Heart failure symptoms

• The procedure is done in a cardiac catheterisation lab under general anaesthesia or sedation.
• A small incision is made in the upper leg, where a Steerable Guide Catheter (a hollow, flexible tube slightly larger than the diameter of a pencil) is inserted through a vein to reach your heart.
• The MitraClip™ implant is attached to the catheter and guided to the mitral valve using advanced imaging.
• The Clip is placed on the mitral valve to bring the valve leaflets together, allowing the valve to close more securely and reduce leakage.
• Your doctor will then perform tests to confirm that the Clip is working properly. In some cases, a second Clip may be implanted for further reducing mitral regurgitation.
• Once the Clip is in place and working properly, the Clip Delivery System and the Steerable Guide Catheter are removed from the body, and the incision in the leg is closed.
• The implanted Clip becomes a permanent part of your heart.

The TMVr procedure usually takes a few hours, but this may vary depending on individual heart anatomy and complexity.

If your team of cardiologists has determined that you would benefit from having this procedure, they may advise you to:

• Take all your  prescribed medications
• Inform your doctor if you are taking any other medications
• Make sure your doctor knows of any allergies you have, especially to medicines, contrast dye, or anaesthesia
• Follow all instructions provided by your doctor or nurse before the procedure

Like any heart procedure, TMVr carries some risks. These may include:

• Bleeding at the catheter site
• Infection
• Irregular heart rhythms (arrhythmias)
• Damage to the blood vessel or heart
• Problems with the clip (movement, leakage, or need for a second clip)
• Stroke
• Kidney problems

Most patients experience relief from symptoms of mitral regurgitation soon after the procedure.

• You will need to stay in the hospital from 1–5 days, depending on your recovery and overall health.
• You will be closely monitored with several heart tests to understand your heart function.
• You may be prescribed blood-thinning medications for some time after the procedure to prevent blood clots.
• You will be given instructions about your medications by your doctor or nurse before you are discharged from your hospital.
• Regular follow-up appointments with your cardiologist are essential.
• Most patients will not need special assistance at home following discharge from the hospital, other than for ongoing needs for any unrelated health conditions.
• At home:
  • Limit strenuous physical activity (such as jogging or activities that cause shortness of breath, grunting, or straining when lifting heavy objects) for at least 30 days, or longer, if your doctor thinks it is necessary.
  • Carefully follow your doctor’s instructions regarding medications you need to take, especially if blood-thinning drugs are prescribed.
  • Call your doctor if you notice side effects, such as rash, bleeding, or upset stomach.
  • Notify your doctor before any medical or dental procedure; you may need to be prescribed antibiotics to avoid potential infection.

After your procedure, you will receive an Implant Identification Card, which your doctor will fill out and which you must always carry with you. This card identifies you as a patient who has a MitraClip™ implant.

Important:

• Show your Implant Identification Card if you report to an emergency room.
• If you require a magnetic resonance imaging (MRI) scan, tell your doctor or MRI technician that you have a MitraClip™ implant. Test results indicate that patients with the MitraClip™ implant can safely undergo MRI scans under certain conditions described on the card.