A mitral clip is a small metal device shaped like a clothespin. There are several sizes, but it is generally smaller than a dime.
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What is a mitral valve clip?
A mitral valve clip is a non-surgical treatment for mitral valve regurgitation or mitral valve prolapse. In a healthy heart, the heart’s four valves open and close as blood flows through them. In mitral valve regurgitation, the mitral valve does not close properly, allowing blood to leak backward through the valve.
An interventional cardiologist uses minimally invasive techniques to place a small clip on the mitral valve. The procedure is done using a wire catheter that is guided to the heart through a vein. The clip helps the edges of the mitral valve close more tightly. Other names for the treatment include MitraClip™, mitral clip, and transcatheter mitral valve repair (TMVR).
At Mass General Brigham Heart and Vascular, we offer leading-edge treatment for all types of heart valve disease, including mitral valve regurgitation.
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Who is a candidate for a mitral valve clip?
A mitral valve clip may be an option for people with severe mitral valve regurgitation or mitral valve prolapse who cannot undergo open-heart surgery for mitral valve repair. A team of specialists will evaluate your valve anatomy to determine if the mitral valve clip is an appropriate option.
A mitral valve clip is often recommended for individuals who are not candidates for open-heart surgery due to age or underlying health conditions.
Benefits of mitral valve clips
For patients who are not candidates for a surgical mitral valve repair, the mitral valve clip procedure offers a minimally invasive treatment option. Interventional cardiologists use a thin, flexible tube (catheter) to place the clip. They don’t have to open the chest to perform this procedure. This approach offers multiple benefits, including:
- Faster recovery
- Less pain
- Shorter hospital stay
The mitral valve clip can improve symptoms quickly. Most people experience reduced shortness of breath, fatigue, and heart palpitations after the procedure.
How to prepare for a mitral valve clip procedure
Before your procedure, your interventional cardiologist will order tests to look at your heart’s function and structure. These tests help determine whether you are a good candidate for a mitral valve clip and allow your care team to plan the procedure:
- Chest X-rays: Uses radiation to view the heart’s structure.
- Electrocardiogram (ECK or EKG): Uses electrodes placed on the skin to measure the heart’s rhythm and rate.
- Echocardiogram: Uses sound waves to get a better picture of the heart’s valves and chambers. This can be performed in two ways:
- Transthoracic echocardiogram (TTE): A noninvasive ultrasound performed by placing a probe on the chest.
- Transesophageal echocardiogram (TEE): A more detailed ultrasound performed by inserting a small probe into the esophagus, which is located close to the heart.
- Specialized CT scan: Provides a detailed 3D image of the mitral valve anatomy to determine if the mitral valve clip is an appropriate option.
Your care team will give you specific instructions to prepare for these procedures. You may need to pause certain medications or stop eating or drinking for a period beforehand.
What to expect during a mitral valve clip procedure
Interventional cardiologists perform the mitral valve clip procedure in a cardiac catheterization laboratory. You will have general anesthesia, so you sleep through the procedure. We will also connect you to devices that monitor your blood pressure, heart rate and rhythm, breathing, and oxygen levels.
During the mitral valve clip procedure, an interventional cardiologist:
- Inserts a catheter through a blood vessel
- Directs the catheter to your heart using imaging guidance
- Guides the mitral valve clip though the catheter
- Positions the clip at the edges of the mitral valve
After placing the clip, the interventional cardiologist removes the catheter from your blood vessel.
What to expect after a mitral valve clip procedure
Most people spend one to two days in the hospital after a mitral valve clip procedure. You can gradually resume your usual activities after returning home.
You’ll see the interventional cardiologist around four to six weeks after the procedure to check that the clip is working properly. Most people continue seeing their cardiologist yearly to monitor their heart health and valve function.
FAQs about mitral valve clips
No, you won’t even know the mitral valve clip is there.
Yes, you can still have MRIs with a mitral valve clip. After your mitral valve clip procedure, you will get a card that explains what types of MRIs you can have.
However, before an MRI, you should tell the imaging technician that you have a mitral valve clip so they can make adjustments for safety.
A mitral valve clip is designed to remain in place permanently to reduce mitral valve regurgitation. However, if the clip is no longer effective and severe regurgitation returns, a cardiothoracic surgeon may need to remove the mitral valve clip.
In some cases, the surgeon may also need to remove the clip and replace the heart valve. If this happens, the mitral valve clip cannot be removed using a minimally invasive transcatheter approach. Instead, open-heart surgery would be required.
Research shows that the mitral valve clip procedure has an 86% success rate, effectively reducing symptoms of mitral regurgitation in most patients.
For those who have undergone the procedure, studies indicate that the mitral valve clip significantly reduces symptoms for at least two years, though long-term effectiveness varies based on individual health and underlying conditions. Regular follow-ups help monitor heart function over time.
