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How A Non-Surgical Treatment For Valve Leakage Was Performed On An Octogenarian

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How A Non-Surgical Treatment For Valve Leakage Was Performed On An Octogenarian
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The patient had been seeing her doctor regularly to bring her hypertension and diabetes under control. A month ago, she experienced difficulty in breathing.

Written by Prerna Mittra |Updated : December 8, 2023 4:01 PM IST

For an 86-year-old female patient with severe mitral regurgitation, a 'transcatheter edge-to-edge repair' (TEER) procedure became a life-saver. It was performed recently by Dr Pankaj Jariwala, a consultant interventional cardiologist from the Somajiguda unit of Yashoda Hospitals. According to Mayo Clinic, in severe mitral regurgitation, the heart has to work harder to pump blood to the body, and this extra effort causes the left lower heart chamber to get bigger. If left untreated, the heart muscle can become weak and it can lead to heart failure.

The patient had been seeing her doctor regularly over the past decade to bring her hypertension and diabetes under control. A month ago, she experienced difficulty in breathing while resting, and was taken to the emergency department. She was diagnosed with acute left ventricular failure by echocardiography because of chordae tendineae rupture (a total loss of tension of one of the mitral valve leaflets), which caused the posterior mitral leaflet to flail, leading to severe mitral regurgitation.

A variety of "supportive interventions", including intravenous diuretics and non-invasive ventilatory assistance were administered to her. Subsequently, doctors advised her to have a surgical repair of the mitral valve once she had completely recovered. The cardiothoracic surgeon, however, refused to do the surgery on her because she is an elderly person. After "meticulous planning and implementation", the hospital finally administered the innovative MitraClip procedure.

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What is a MitraClip?

According to the doctor, the MitraClip procedure is a "minimally invasive operation" that treats malfunctions of the mitral valve. A thin tube -- also known as a catheter -- is used by medical professionals to gain access to the mitral valve. To reach the cardiac region, this catheter is carefully inserted into a vein located in the lower limb.

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This procedure does not necessitate the act of thoracotomy (an incision made between the ribs to see and reach the lungs or other organs in the chest or thorax) or the temporary cessation of cardiac activity. The implantation method is characterised by its efficiency with a usual duration of 1 to 3 hours. The hospital stay is brief.

There is evidence that MitraClip is effective in improving patient outcomes and reducing mortality rates.

According to mitraclip.com, the device is a "small metal clip covered with a polyester fabric", implanted on your mitral valve. As mentioned earlier, the clip is inserted through a catheter without the need to temporarily stop your heart. There can be up to four different clip sizes.

"The clinical data gathered from patients who had undergone the MitraClip non-surgical intervention demonstrates that mitral regurgitation was significantly reduced in a short amount of time. In the immediate aftermath of the procedure -- performed to address the problem of a leaking valve -- patients should anticipate seeing a significant improvement in both the symptoms they are experiencing and their overall quality of life.

"This case was no exception; post-procedure, the lady was discharged within two days and was completely fit. She is doing perfectly fine," said Dr Jariwala.