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Saturday, January 16, 2010
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Medical Update

Mitral clip: Alternative to open heart surgery

Mitral regurgitation is a common problem among people suffering from heart diseases. It is a condition in which the heart's mitral valve (valve between two left sided chambers that controls blood flow between them) does not close tightly, allowing blood to flow backward into the heart. When the mitral valve does not function properly, blood can not move through your heart or to the rest of your body as efficiently. Mitral valve regurgitation can make you fatigue, exercise intolerance and y may experience shortness of breath and swelling.

The main causes are classified as degenerative (with valve prolapse) and ischaemic (i.e. due to consequences of coronary diseases) or rheumatic heart disease. This disorder generally progresses insidiously, because the heart compensates for increasing regurgitant volume by left-atrial enlargement, causes left-ventricular overload and dysfunction and yields poor outcome when it becomes severe.

If regurgitation is mild, no specific treatment may be required; however, the person may need to be evaluated periodically and may need to take antibiotics before dental and medical procedures. More serious regurgitation may be treated with surgery decided by a specialist.

Traditionally the treatment of severe mitral regurgitation is done with open heart surgery at which most people are scared of. Interventional cardiologists created an alternative to open heart surgery for this purpose by developing a mitral valve clip. To alleviate mitral valve regurgitation, cardiologists insert a catheter into the patient's groin that travels up into the mitral valve similar with the procedure in angiogram. The clip is fed through this catheter, where it finally grasps and tightens the valves' leaflets ---effectively preventing blood from leaking. The clip remains in place while the catheter is removed. The entire procedure takes approximately two hours, almost the same duration as for open-heart surgery. The difference is in the recovery - down from months to just weeks.

The mitral clip procedure is good for patients who have a weak heart and may not make it through traditional surgery. The procedure is being investigated in clinical trials in 38 hospitals across in USA.

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