More than 4 million Americans have a leaky mitral valve (mitral regurgitation). Of those more than 1.5 million people have a significant leakage that can lead to shortness of breath, fatigue or abnormal heart rhythms.
The mitral valve is one of four valves in the heart. The purpose of a valve is to keep blood flowing through the heart in the correct direction. The mitral valve is located between the left atrium (which accepts blood from the lungs) and the left ventricle (which pumps the blood out to the rest of the body through the aortic valve). When the mitral valve leaks, blood that has passed into the left ventricle — and should be pumped out to the rest of the body — leaks back into the left atrium.
This backflow or leaking of the mitral valve can lead to fluid in the lungs called “heart failure” or “pulmonary edema.” It can make people feel short of breath or wake up at night unable to breathe. People with significant mitral valve leakage can be more tired, and sometimes their heart even goes out of rhythm.
People who have moderate to severe or severe mitral regurgitation (leakage) may benefit from having their valve fixed. The valve can be fixed surgically in many cases, but the person may be too sick or have so many problems that they may not be a good candidate for traditional surgery, which involves opening the chest and repairing or replacing the valve.
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There is an alternative for some individuals. A device called a MitraClip is now available to a number of people who have significant mitral regurgitation but are not good candidates for traditional surgery.
The MitraClip is a small clip-like device, approximately 1-inch x 3/8-inch that looks similar to a small clothespin. It can be opened beneath the leaky part of the mitral valve, and just that part of the mitral valve can be clipped together. This reduces the leakage significantly and the patient feels much less short of breath. Admissions to the hospital for heart failure are reduced, and the patient has an improved quality of life.
The MitraClip is currently approved for patients who are high-risk surgical candidates with degenerative mitral regurgitation. It is not yet approved for functional regurgitation. There is no age limit. The procedure is done through the vein in the leg, and the hospital stay is usually one to two days.
Dr. Paula Hollingsworth, an interventional cardiologist with Baptist Health Medical Group Lexington Cardiology, practices at Baptist Health Lexington.