Published on April 22, 2019

Transforming lives

A minimally invasive therapy repairs leaky heart valves

For decades, the standard therapy for a common type of leaky heart valve with severe symptoms was open-heart surgery.

But now there’s a minimally invasive procedure available for people who can’t tolerate open-heart surgery. It’s called MitraClip therapy. Only a small fraction of hospitals nationwide offer it—and St. Mary Medical Center is one of them. The highly skilled cardiology team at St. Mary is also the only one in Bucks County performing it.

The MitraClip is a nonsurgical way to repair a leaky mitral valve, one of four valves in the heart.

When the mitral valve doesn’t close tightly, blood leaks backward inside the heart—a condition known as mitral regurgitation.

“Blood flows in the wrong direction, which strains the heart and over time can raise the risk of serious heart problems, such as heart failure,” says Roi Altit, MD, an interventional cardiologist with St. Mary Comprehensive Cardiology Associates.

Mitral regurgitation— the most common heart valve problem—affects roughly 10 percent of people 75 and older. When severe, it can profoundly affect a person’s quality of life, causing shortness of breath even at rest, extreme fatigue, and swollen legs and feet.

Highly successful solution

Not everyone is healthy enough for open-heart surgery to repair or replace a leaky mitral valve. And that’s where the MitraClip comes in. If surgery is too dangerous, MitraClip is an option for patients with a moderate to severe leaky mitral valve—and it has a procedural success rate approaching 100 percent.

“It opens up treatment for a large number of people who otherwise would have to cope with debilitating symptoms,” Dr. Altit says. “It’s life-changing.”

Studies show, in fact, that the percentage of patients with shortness of breath at rest or only a little exertion drops from 40 percent to 1 percent in a year after the procedure.

“It also brings a dramatic reduction in hospitalizations for heart failure,” says Dr. Altit, who has performed the procedure more than 60 times since the U.S. Food and Drug Administration approved the MitraClip.

Gentler procedure, faster healing

Unlike standard surgery, MitraClip therapy doesn’t require opening the chest and temporarily stopping the heart.

Instead, doctors make a small incision in the groin. Then they advance the MitraClip device—a small clip—through a tiny tube inside a vein and toward the heart.

Meanwhile, an imaging specialist provides 3-D ultrasound views of the clip’s position and the mitral valve. That allows cardiologists to clip together a small area of the mitral valve’s two flaps that control blood flow and reduce the leak.

“For many people, symptoms improve almost immediately,” Dr. Altit says. And compared to open-heart surgery, recovery is far faster—and easier.

“The difference is like day and night,” Dr. Altit says. “With the MitraClip, you don’t go through a prolonged hospital stay or rehabilitation. You come in, have the procedure and stay overnight. Then you go home in the morning and, in a very short time, get your life back.”