Mitral valve disease is classified into two types.
Both types of conditions can lead to breathing difficulties, increased fatigue, and swelling in the feet, legs, and abdomen. Surgery is often necessary to address these issues, but some individuals might benefit from less invasive options like percutaneous or catheter-based treatments.
The choice between surgical and percutaneous interventions depends on various factors. To assist healthcare providers in making the best treatment decision, a thorough examination and tests such as CT scans and echocardiograms are necessary. This is because many treatments require a specific understanding of the patient’s anatomy, which can only be obtained through specialized imaging. To minimize the need for repeat testing, it is crucial to ensure that healthcare providers have access to prior test results and images.
The types of MR are degenerative mitral regurgitation (DMR) and functional mitral regurgitation (FMR). To determine the type of MR the patient has, they will have an echocardiography in addition to other diagnostic tests. When determining the appropriate course of treatment for a patient, the healthcare provider will take into account the patient’s kind of MR in addition to other relevant considerations.
Mitraclip: For patients with DMR or FMR who are at a high risk of complications from open heart surgery, the FDA has approved the MitraClip.
Mitraclip is place by:
Percutaneous annuloplasty: The FDA has not yet given its approval to these procedure, but the healthcare provider may discuss them with the patient if their valve structure or other circumstances make them a better candidate for the treatment.
Transcatheter mitral valve replacement: Patients who are considered to be too high risk for conventional valve surgery and are unable to undergo a MitraClip treatment may be candidates for TMVR.
Many persons with mitral stenosis experienced rheumatic fever throughout their childhood. Others get it as a result of a combination of diseases and aging that lead to the formation of scar tissue and calcium on the mitral valve and its surrounding tissue.
Although percutaneous treatment is occasionally an option, cardiac surgery is frequently the best course of action for mitral stenosis.
Percutaneous mitral balloon valvuloplasty (PMBV): The mitral valve is opened using a small balloon attached to a catheter.
The majority of individuals who have mitral stenosis caused by rheumatic fever are candidates for this surgery. If this is the best course of action for the patient, the healthcare provider will assess it using an echocardiography.
Transcatheter mitral valve repair (TMVR): The healthcare provider may discuss TMVR if the patient has a significant risk of complications from cardiac surgery and cannot have PMBV. Patients with mitral stenosis are undergoing this treatment as a part of a clinical trial.
For individuals who have undergone mitral valve repair with a ring or band or have received a bioprosthetic mitral valve replacement, there is a potential for degeneration to occur as time passes. This degeneration can lead to conditions such as mitral regurgitation or stenosis. Both of these issues may be addressable through percutaneous procedures, specifically either a MitraClip or Transcatheter Mitral Valve Replacement (TMVR).
MitraClip for patients with a degenerated mitral valve
MitraClip may be considered as a treatment option for certain individuals experiencing the deterioration of a surgical mitral valve repair involving a ring or band. Your healthcare provider will assess your specific case and discuss the suitability of this procedure for your condition.
Mitral valve-in-valve or valve-in-ring replacement
Patients with a degenerated bioprosthetic mitral valve, originally placed during surgery, may be eligible for a catheter-based valve-in-valve/valve-in-ring replacement procedure. This FDA-approved treatment involves the insertion of an aortic valve within the existing mitral valve. To determine the suitability of this treatment for you, your doctor will assess your valve anatomy.
The procedure is performed using local anesthesia, along with conscious sedation involving IV sedatives and pain relief medication.
A catheter is introduced through an incision at the top of your thigh into a vein. Guided by X-ray imaging, your doctor navigates the catheter to reach your mitral valve, where the new valve is subsequently positioned within the existing mitral valve.
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