Patient guide to MitraClip therapy for selected patients with mitral regurgitation.

Understanding the condition

What Is mitral regurgitation?

Mitral valve regurgitation is a common type of heart valve disease, also called valvular heart disease. In this condition, the valve between the left heart chambers doesn't close fully. Blood leaks backward across the valve. If a lot of blood leaks backward, the rest of the heart and body doesn't get enough blood. Mitral valve regurgitation can make you feel very tired or short of breath.

Causes

• Mitral valve prolapse (valve flaps do not close properly)
• Rheumatic fever
• Heart attack
• Congenital heart defects (heart condition present from birth)
• Thickened or weakened heart muscle (cardiomyopathy)
• Damaged valve-supporting cords
• Infection of the heart valve (endocarditis)
• Previous radiation therapy to the chest

Risk factors

• Older age
• Previous heart attack
• Heart infections such as endocarditis
• Congenital heart defects
• Other mitral valve diseases
• Radiation exposure to the chest area

Signs and symptoms

Symptoms may begin suddenly if:

• A heart attack damages the muscles around the mitral valve
• The supporting cords of the valve break
• An infection damages the heart valve

In many people, symptoms develop gradually and may include:

• Cough
• Fatigue or tiredness
• Lightheadedness or dizziness
• Rapid breathing
• Palpitations (feeling of fast or irregular heartbeat)
• Shortness of breath during activity
• Difficulty breathing while lying down
• Sudden breathlessness during sleep
• Frequent urination at night

Diagnosis and tests Echocardiogram (heart ultrasound)

• Transesophageal echocardiography (TEE)
• CT scan of the heart
• Cardiac MRI
• Cardiac catheterization (in some cases)

Treatment options

Medicines may help to:

• Reduce strain on the heart
• Control blood pressure
• Prevent blood clots
• Control irregular heartbeat
• Remove extra fluid from the body

Common medicines include:

• Beta-blockers
• ACE inhibitors
• Blood thinners
• Water tablets (diuretics)

Lifestyle changes

• Eat a low-salt diet
• Stay active as advised by your doctor
• Attend regular follow-up visits and heart check-ups

When to contact your doctor

Contact your doctor if your symptoms worsen or do not improve with treatment. Seek medical attention if you develop signs of infection, such as:

• Fever
• Chills
• Feeling generally unwell
• Headache
• Muscle aches

When is surgery or a procedure needed?

A procedure may be needed if:

• Symptoms become worse
• The heart becomes enlarged
• Heart function becomes weak

Minimally invasive treatment

Some patients may benefit from procedures like MitraClip, which repairs the leaking valve without open-heart surgery.

MitraClip procedure

What is MitraClip?

MitraClip is a minimally invasive procedure used to treat mitral regurgitation, a condition in which the heart's mitral valve does not close properly and blood leaks backward. A small clip is placed on the valve to help it close better and reduce leakage.

Who may benefit from MitraClip?

Patients with mitral regurgitation who are not suitable for open-heart surgery may benefit from MitraClip.

Before and during the procedure

Procedure preparation and hospital process

• The procedure is performed under general anaesthesia.
• A small incision is made in the groin area.
• A catheter is inserted through the femoral vein and guided to the heart.

Step-by-step procedure explanation

• The patient is given general anaesthesia.
• A small cut is made in the groin.
• A catheter is passed through a vein to the heart.
• The clip is guided to the mitral valve.
• The clip is positioned to help the valve close properly.
• The catheter is removed and the incision is closed.

What happens after mitral valve repair surgery?

• You may spend 1-2 days in the intensive care unit (ICU) for close monitoring
• Your heart rate, breathing, and blood pressure will be checked regularly
• You will spend a few more days in the hospital for recovery
• Your healthcare team may guide you about cardiac rehabilitation
• You will receive instructions on caring for your incision at home
• Most people stay in the hospital for about a week after surgery

Benefits and recovery expectations

• Minimally invasive procedure
• Less pain and scarring compared with open-heart surgery
• Faster recovery time
• Can be performed in patients unsuitable for open-heart surgery

What is the recovery time?

• Recovery usually takes about 4-8 weeks.
• Some people may need more time to fully recover.
• Recovery differs from person to person.

What should I expect after going home?

• Get enough rest
• Slowly return to normal activities
• Set small and manageable goals
• Avoid overexertion during recovery

What activities should I avoid during recovery?

Your doctor will advise when it is safe to:

• Drive
• Lift heavy objects
• Exercise or take walks

Why are follow-up visits important?

• Regular follow-up visits help monitor recovery
• Yearly echocardiograms may be needed to check valve function
• Some patients may need antibiotics before certain procedures to prevent infection

How long does mitral valve repair last?

• Mitral valve repair is usually long-lasting
• Most patients do not require another surgery for many years

Myths and facts

Frequently asked questions (FAQs)