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Sep 25, 2018 12:00
A small device is about to make a big difference in millions of lives.
Mitral regurgitation occurs when the valve that separates the main pumping chamber from the heart of the lungs is unable to close properly, allowing the blood to move backward rather than forward. Patients with a failing heart often develop mitral valve insufficiency that can cause shortness of breath, fatigue and swelling. The repair of the leaky mitral valve or not influences the patient's survival and general condition has long been controversial.
New research shows that the MitraClip device can be used to treat patients with significant mitral regurgitation and severe heart failure, improving their quality of life and reducing their mortality rate. "The magnitude of the patients' response in this trial was quite impressive," said Frederick Welt, MD, associate chief of cardiovascular medicine at the University of Utah Health. "The probability of death after two years was 29% in patients who received the clip, against 46% in patients treated with drugs alone."
Heart failure occurs when the heart expands or grows. This may be due to a previous heart attack or heart disease. When the heart is dilated, it does not pump effectively and can become deformed while trying to compensate. This change in shape can affect the mitral valve and prevent its complete closure and leakage. "Previously, it was not known that mitral valve fixation in these patients would have a significant impact on overall heart failure," Welt said. "This new research is a surprising discovery in that it refutes this hypothesis."
The MitraClip is not a new device. "We used the MitraClip device to treat patients found to be inoperable with severe mitral insufficiency associated with a poor valve, not necessarily a bad heart," said Craig Selzman, MD, division chief. of Cardiothoracic Surgery and the Surgical Director of the Heart Transplantation and Mechanical Circulatory Equipment Program at the University of Utah. "The results of this study suggest that a large group of patients with advanced heart failure would potentially have an additional treatment option. The FDA must now take this information and decide if it will label this device for this use. We hope that they will do it quickly. "
The introduction of MitraClip is an intracardiac device that connects the two oscillating components of the mitral valve. The clip is inserted into the heart by a vein of the leg and guided in place with the help of an echocardiogram and an x-ray. The patient is then observed for 24 to 48 hours and then released. "The fact that it is a minimally invasive procedure is important for patients with heart failure who may be too sick for open-heart surgery," Welt said.
It is currently estimated that between 1.6 and 2.5 million people could benefit from this new treatment for heart failure. "It could change the lives of these patients," said Welt. "Not only could this extend their life, it could also improve their quality of life. The future could be a lot brighter. "
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