The Mitraclip: A minimally invasive procedure used in Santander to opérate on fragile hearts

• The Mitraclip is a tiny V-shaped structure made up of small branches that open and close. It is implanted into the mitral valve of the heart to reduce mitral insufficiency, improving the patient’s fatigue and preventing progressive damage to cardiac function.  

• The procedure is minimally invasive as it is performed through the groin until it reaches the heart. This type of procedure avoids opening the thorax and reduces mortality risks for patients with fragility and/or comorbidities.

• The FCV has performed three procedures of this type and the results have been successful.

Bucaramanga, March 2022. Activities such as walking, standing, and even simply getting out of bed, caused  Leonor García Sandoval, 83 years old, severe fatigue, and in some cases, she was hospitalized. Her health complications, diagnosed 10 years ago, were caused by several heart conditions, including severe mitral insufficiency and a cardiac arrhythmia known as atrial fibrillation. 

"I suffered tachycardias and I was also diagnosed with arrhythmias. I was treating the disease with anticoagulants and other medications. They referred me to the specialist and told me that due to my age, the procedure that they needed to perform was very risky", said Leonor.

Jaime Rodriguez, Cardiologist, echocardiographist, and member of the Heart Failure and Transplant team of the FCV, assured us that Leonor's case is due to a problem related to the heart pumping where the mitral valve, which is the organ that separates the atrium cavities and the left ventricle, is completely insufficient. "This causes that, when this valve closes, a significant amount of blood returns to the lung and that is where the fatigue occurs"

Although this condition is normally treated with cardiac surgery that requires opening the thorax, the risks were very high for her due to her comorbidities. For this reason, a modern technique known as Mitraclip was applied, which does not require a surgical wound and brings considerable improvements to the quality of life of those who receive it.

Libardo Augusto Medina, Interventional Cardiologist at the FCV, who performed the patient's procedure, explained that to implant the Mitraclip, a catheter (a kind of tiny tube) needs to be inserted through the groin to reach the heart. Once there, the cardiac cavities are crossed, specifically from the right atrium to the left atrium, to make a fold in the middle of the mitral valve and in that way reduce the insufficiency.

Dr. Medina explained that the procedure, as it is done through the leg, is more tolerated by high-risk patients and allows a very quick recovery. In just 4 days, Leonor was discharged from the hospital and returned to her home to continue her rehabilitation therapies.

"These patients who have this procedure must continue cardiac and pulmonary rehabilitation therapy. The treatment program includes 36 sessions that can take about a month or a month and a half, which will not only allow them to improve their cardiopulmonary conditioning but will also help improve their mobility", said Dr. Rodriguez.

How does Mitraclip work?

The technical name of the procedure is Percutaneous Edge-to-Edge Mitral Valve Repair. It is a tiny V-shaped piece made up of small branches which open and close.

When it enters into the mitral valve of the heart, the branches open completely to capture the 2 mitral leaflets and then close, to reduce the opening where blood is returned and  then correct the mitral insufficiency.

This procedure is performed in a Cath Lab and requires the essential participation of an echocardiographist, who uses imaging to guide the interventional cardiologist  in the correct implantation of the Mitraclip.

The importance of this procedure is related to the fact that it is the only percutaneous intervention (through the skin) that can be offered in the case of mitral valve insufficiency.

The FCV has performed 3 procedures of this type and the results have been successful.