Clip Closes Door on Leaky Heart Valves
Novel Procedure May Offer Option to Surgery for Mitral Valve Regurgitation
March 17, 2010 (Atlanta) -- A clothespin-type device that clips together the partially open doors of leaky heart valves may spare some patients the need for open heart surgery, doctors say.
In a new study, the clip was safer and worked nearly as well as surgery for people with the leaky valve condition known as mitral valve regurgitation.
But the patients were only followed for one year -- not enough time to truly gauge the effectiveness of the new technique, some experts say.
Repairing Mitral Valves
About 250,000 Americans are diagnosed with mitral valve regurgitation each year. The mitral valve is like a saloon door that opens to let blood flow into the heart's main pumping chamber. When it fails to close properly, blood flows backward, sapping the efficiency of the heart. Over time, as the heart continues to weaken, patients can develop life-threatening heart failure.
For people with severe symptoms, such as breathlessness when walking across the room, doctors typically offer surgery, which involves splitting open the chest to repair or replace the valve. About 100,000 Americans have mitral valve surgery each year, says study head Ted Feldman, MD, of NorthShore University Health System in Evanston, Ill.
If the patient is too old or has too many other health problems to tolerate surgery, heart failure medications are given, he says.
These are the patients most likely to benefit from the new device, called MitraClip, experts say. It's already on the market in Europe and is awaiting FDA approval.
The tiny clip is mounted onto a catheter and then threaded into the heart through an incision in an artery in the groin. The technique is similar to that used in angioplasty procedures to open clogged heart arteries.
Clip May Help Repair Leaky Mitral Valves: Study Details
The new study involved 279 patients: 184 were assigned to get the MitraClip and 95 to surgery. The clip procedure was attempted in 178 patients and successful in 137.
The findings were reported at the annual meeting of the American College of Cardiology (ACC).
Ten percent of people treated with the clip experienced major complications within 30 days, compared to 57% who underwent surgery. There were no deaths with the clip; two surgery patients died.