Mitral Valve Regurgitation
Treatment
Once a patient shows symptoms, repair of the valve is generally recommended. Treatment for mitral valve regurgitation includes medical therapy; surgical intervention; and more recently, some less-invasive techniques that involve using a catheter-based procedure to repair or replace the mitral valve.
Transcatheter edge-to-edge repair for mitral valve regurgitation
In recent years, the U.S. Food and Drug Administration (FDA) has approved a few innovative transcatheter treatment options for mitral valve regurgitation (or leakage) without the need for open-heart surgery: the MitraClip Delivery System (approved in 2013) and the PASCAL Precision Transcatheter Valve Repair System (approved in 2022).
Both procedures work similarly and are equally safe and effective. A recent study compared the two procedures.1 The MitraClip and PASCAL procedures follow this basic process:
- An interventional cardiologist uses a thin, plastic tube called a catheter to implant a large tube called a sheath into the patient’s vein in the patient’s groin (femoral vein). Through the sheath another tube called a catheter is passed from the right side of the heart to the left side of the heart through the tissue by creating a path through the tissue called the septum (Trans-septal) Once the catheter is in place, the clip may be advanced through this catheter.
- After the clip device is threaded up to the patient’s heart, the cardiologist then implants the clip device into position directly over the center of the two tissue flaps, or leaflets, of the mitral heart valve, which is the valve that controls blood flow between the top-left (atrium) and bottom-left (ventricle) chambers of the heart.
- Once properly implanted, the clip device can grasp the two flaps together to reduce the backflow of blood through the valve (mitral regurgitation).
- After the cardiologist ensures the clip device is firmly in place, the cardiologist detaches the clip device from the catheter and removes the catheter from the patient’s body.
When comparing the two procedures, the main differences come down to each clip device's physical and technical properties (i.e., size and structure, material construction of each device, etc.)2 If you have mitral regurgitation and need a mitral valve repair, discuss the MitraClip and PASCAL procedures with your doctor to determine which procedure is the best treatment option for you.