Patients with a leaky heart valve have new hope.
The heart has valves that control the flow of blood. Over time, these valves, particularly the aortic or mitral valves, can become leaky, a condition called regurgitation. When regurgitation becomes significant, patients may experience problems like difficulty breathing or difficulty being active.
A new study in the New England Journal of Medicine describes results of a new heart valve procedure that can save lives for patients with significant mitral valve regurgitation.
Dr. Greg Stone, a professor of medicine at Columbia University College of Physicians and Surgeons, and colleagues evaluated the use of the MitraClip, a clip that can be placed on the mitral valve using a catheter, in patients with moderate-to-severe or severe mitral gurgitation as a consequence of heart failure. The clip is designed to bring the leaflets of the valve closer together and decrease the leakiness of the valve.
Dr. Stone studied a total of 614 patients – 302 patients received a MitraClip and 314 patients did not receive the procedure. Both groups continued on the best medications available. After 24 months, patients who received a MitraClip had a 32 percent lower annual rate of admission to the hospital for heart failure (35.8 percent vs. 67.9 percent) and a 17 percent lower risk of death (29.1 percent vs. 46.1 percent).
Dr. Stone’s study showed that the MitraClip procedure can improve outcomes dramatically in patients with significant mitral regurgitation and heart failure.
There are a few caveats.
First, before having the MitraClip placed, it is important that all patients be on the best medications available for their symptoms, as these can often improve symptoms and treat heart failure.
Second, the MitraClip is a new procedure and it may take some time for physicians to be comfortable with its use.
Lastly, although the MitraClip is an option for patients who ultimately develop disease, it is important to emphasize good control of risk factors like high blood pressure to prevent heart failure and mitral regurgitation from occurring in the first place.
Overall, for patients with advanced mitral regurgitation and heart failure who continue to have symptoms, Dr. Stone’s study shows that the MitraClip is a new hope.
Anant Mandawat, MD, a graduate of Lakeside High School, Yale, Harvard, and Duke, is a cardiologist and director of Cardio-Oncology at Emory University.