MitraClip is a non-surgical procedure used to reduce the severity of mitral regurgitation.
It is mainly intended for people for whom heart surgery carries a higher risk.
Understanding the basics
The heart acts as a muscular pump that allows bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood to circulate throughout the body.
To ensure that bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood flows in the right direction, without going backward, it has four valves.
These valves open and close with each heartbeat, much like doors, guiding bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood from one chamber to another.
The mitral valve
One of these valves is the mitral valve, located between the left atrium and the left ventricle.
It can be imagined as a door with two leaflets that allows bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood to pass from the left atrium to the left ventricle.
When the heart contracts to pump bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood into the body (brain, arms, intestines, etc.), this valve closes tightly to prevent bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood from flowing backward.
Mitral regurgitation
Over time, the mitral valve can lose its ability to close properly for various reasons.
It is then said to “leak,” or that mitral regurgitation is present.
In this situation, some of the bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood flows back into the left atrium instead of being pumped forward into the body.
The severity of the leak is generally described as:
- mild
- moderate
- severe
The more significant the leak, the harder the heart has to work to compensate.
Over time, significant mitral regurgitation can lead to fatigue, shortness of breath, and sometimes fluid buildup in the lungs, which are signs of heart failure.
Read more: Chronic mitral regurgitation
Treatment options for this condition
When mitral regurgitation is severe and requires intervention, the standard treatment remains heart surgery.
Depending on the situation, this may involve:
- repairing the valve (mitral valve repair)
- or replacing it with a biological or mechanical valve
However, some individuals have a more fragile health condition or associated medical issues that make open-heart surgery too risky.
In these situations, a less demanding approach for the body may be considered, such as MitraClip, which allows treatment of the valve without open-heart surgery.
MitraClip
MitraClip is a catheter-based procedure that reduces significant mitral regurgitation, meaning it decreases the leakage of the mitral valve.
How does it work?
In mitral regurgitation, the two leaflets of the valve do not close properly.
Instead of forming a tight seal, the valve allows bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood to flow backward.
This can be compared to a door that does not fully close — similar to a “saloon door” that remains partially open.
The principle of MitraClip is simple:
it acts like a small clip, similar to a clothespin, that brings the two leaflets of the valve together at the site of the leak.
By bringing these two leaflets closer, the leak is reduced and bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood flows more efficiently in the correct direction.
How is the procedure performed?
The procedure is carried out in a cardiac catheterization laboratory, the same type of room used for heart catheterization procedures.
Pre-admission visit
Before the procedure, a pre-admission visit is usually scheduled.
During this visit:
- the procedure is explained
- questions can be asked
- bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood tests are performed
Consent: an essential step
In most cases, information about the procedure — its purpose, benefits, and risks — has already been discussed during a previous visit.
On the day of the procedure, an important step remains: signing the informed consent form.
This document confirms that the information has been understood, that questions have been addressed, and that the decision to proceed with the MitraClip is made freely and knowingly.
This simple but essential step ensures that everything proceeds with full understanding.
What are the risks?
Like any procedure performed داخل the bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood vessels and the heart, MitraClip carries certain risks.
The most common is bleeding, usually at the catheter insertion site.
Other complications are less common (less than 1 in 100 cases):
- fluid accumulation around the heart (pericardial effusion)
- stroke
- need for emergency surgery
Complete detachment of the device is extremely rare and has practically not been observed.
A short hospital stay
On the day of the procedure, a short hospital stay is planned, usually limited to one or two days.
The person must arrive fasting.
Upon arrival, they are taken to a preparation area where the nursing team ensures that everything is ready before the procedure.
If anxiety or nervousness is present, a mild medication may be given to help relaxation.
This medication is not mandatory.
The day of the procedure
Fasting from midnight is generally required.
Preparation takes place in a room near the catheterization laboratory.
The person wears a hospital gown.
An intravenous line is placed in one arm to allow medication administration during the procedure.
The groin area is shaved to allow insertion of the catheter into the femoral vein, on either the right or left side.
Preparation in the procedure room
At the scheduled time, the person is transported on a stretcher to the procedure room.
The environment is similar to an operating room.
The medical team — physicians, nurses, and technicians — wear gowns, masks, and surgical caps.
The room is kept cool, sometimes cold, to ensure proper functioning of imaging equipment.
A blanket is provided for comfort.
Anesthesia
Comfort remains a priority throughout the procedure.
A medication may be given beforehand to help relaxation.
For optimal comfort, the procedure is performed under general anesthesia, usually of short duration.
This also allows the use of an ultrasound probe inserted into the esophagus, the tube connecting the mouth to the stomach.
This part of the procedure is not felt and is not remembered.
Echocardiographic guidance
A transesophageal echocardiogram is used to guide the procedure.
This test, similar to a gastroscopy, provides detailed images, as if the heart were being observed live.
These images help position the device precisely to bring the valve leaflets together and reduce the leak.
Read more: Transesophageal echocardiography
Final preparation
Once everything is ready, the groin area is carefully disinfected.
In certain situations, the neck area may also be prepared.
A sterile drape is placed, and final monitoring equipment is set up.
The procedure begins
The procedure is performed under general anesthesia from start to finish.
To access the heart, a puncture is made in a vein in the groin, called the femoral vein.
A plastic tube, called an introducer, is then inserted.
It serves as a stable entry point for the instruments used throughout the procedure.
A catheter is advanced through the vein to the heart.
The path follows the femoral vein, then the inferior vena cava, to reach the right atrium.
To reach the left atrium, a passage through the interatrial septum — the wall separating the two atriaThe atria are the two upper chambers of the heart. They act as reservoirs for blood that will fill the ventricles. — is required.
This step is performed precisely with the help of transesophageal echocardiographic guidance.
At the level of the mitral valve
Once at the mitral valve, the location of the leak is identified using ultrasound imaging.
The device is then positioned to bring the two valve leaflets together, much like a clip holding them in place.
Depending on the situation and the severity of the leak, one or more devices may be used to achieve the best possible result.
Immediate assessment of the result
Once the leaflets are brought together, echocardiography allows assessment of the residual leak — that is, how much leakage remains.
The result is evaluated immediately.
If the leak is still too significant, an additional device may be placed to improve the seal.
What to expect
This procedure primarily aims to reduce symptoms related to mitral regurgitation, such as shortness of breath and fatigue.
It also helps reduce the risk of hospitalization for heart failure, particularly by limiting fluid buildup in the lungs.
After the procedure
If recovery is smooth, discharge is usually granted quickly, often the next day or within 24 to 48 hours.
Precautions
MitraClip is a small metallic device that holds the mitral valve leaflets together.
Like any implanted material, it can promote blood clot formation.
Antiplatelet medication is therefore usually prescribed for about six months.
In rare cases, the device may be exposed to infection if bacteria enter the bloodstream.
Good oral hygiene is essential.
In some situations, preventive antibiotics may be recommended before dental procedures or certain surgeries.
Read more: Prevention of infective endocarditis
Follow-up
Follow-up is usually managed by the referring physician.
It often includes repeat echocardiograms over time to assess the reduction of the leak and its evolution.
At home
Daily activities can gradually be resumed in the days following the procedure.
Baths and swimming pools should be avoided for the first three to four days due to the puncture site in the groin.
Showering is allowed.
Mild discomfort or stiffness in the groin area may be present for a few days.
Applying dry heat, such as a heating pad, can help relieve discomfort.
Conclusion
MitraClip is an effective treatment option for certain individuals with mitral regurgitation, especially when surgery carries a higher risk.
While it does not replace all surgical approaches, it can, in selected cases, improve symptoms and quality of life.
Appropriate medical follow-up remains essential to ensure the best long-term outcomes.
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