A simple clip could increase quality of life for thousands of patients with a common heart problem

The interventional cardiology team at the Montreal Heart Institute (MHI) recently conducted the first clinical procedure in Canada using the MitraClip system, which is designed to treat patients suffering from mitral valve failure, a very common heart defect that affects an estimated 1 out 5 people to various extents starting at the age of 55.

The MHI has implemented a treatment program for this condition and so far is the centre that has performed the most procedures in Canada with the MitraClip system.

An effective treatment with few complications

This innovative and minimally invasive procedure is an alternative to heart surgery. Until now, mitral valve failure has been treated with medication or open-heart surgery depending on the degree of severity. The MitraClip system was designed by Abbott Vascular for inoperable or very high-risk surgical patients and can provide lasting treatment for acute mitral regurgitation. The risk of complications is low compared to traditional surgery, and patients are discharged from the hospital within 48 hours of the procedure.

The first procedure was performed by a multidisciplinary team made up of cardiologists Anita Asgar, Anique Ducharme, Raoul Bonan and Arsène Basmadjian along with anesthesiologists Jennifer Cogan and Baqir Qizilbash. "All initial cases went well, and we believe that the longterm outcomes for this procedure will be favourable," stated Dr. Anita Asgar, interventional cardiologist and Assistant Professor in the Faculty of Medicine at Université de Montréal. "Since it allows patients to regain autonomy and quality of life, we believe that this treatment will reduce the number of hospital admissions and visits to emergency due to symptom reoccurrence."

The procedure consists of using a catheter to guide the MitraClip, a simple clip device, through the femoral vein to the left atrium of the heart and then pushing it into the ventricle. The clip is then positioned so that it holds the anterior and posterior flaps of the mitral valve together. This creates a double orifice opening that allows blood to flow on both sides of the clip, which mechanically restricts regurgitation.

About mitral valve failure

Mitral valve failure (or mitral valve regurgitation) is the most common type of heart valve disease. This condition occurs when the anterior and posterior flaps of the valve do not close completely, which causes abnormal blood backflow from the left ventricle to the left atrium. The bigger the leak, the more blood the left ventricle has to pump to maintain adequate cardiac output. In the long term, mitral valve failure can lead to many complications, such as left ventricle dilation, atrial fibrillation and heart failure. In most cases, someone with mitral valve failure has no symptoms. Rarely, and at a generally advanced stage, the person can experience breathlessness, mild chest pain or general fatigue. In most cases, mitral valve failure is discovered by a doctor during a clinical exam.