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Cath Lab Procedures

- Structural

Transcatheter mitral valve edge to edge repair (Mitraclip)

These are procedures that take place in the catheter laboratory under local anaesthetic and sometimes with the addition of sedation administered into a vein. The procedure can be a day case procedure or sometimes requires an overnight stay. This procedure is performed if you have an issue with the electrical functioning of the heart.

The ablation procedure is slightly different depending on the underlying condition that is being treated.

Some examples of these procedures are described below.

This is a procedure to treat a condition known as mitral regurgitation - leaking of one of the heart valves. Mitral regurgitation is traditionally treated using surgical mitral valve repair or replacement. There are some patients who due to advanced age, frailty or co-existing medical conditions are unsuitable for conventional mitral valve surgery and may be offered a transcatheter (keyhole) repair known as a Mitraclip.

Mitraclip is the name of the brand of edge-to-edge repair that is used in the majority of cases, however, lately new devices have come on to the market. Wythenshawe Hospital is one of 6 centres in England that is commissioned by NHS England to perform Mitraclip.

In order to be assessed for suitability for Mitraclip you will have had an extensive pre-operative workup including evaluation by a cardiac surgeon, Cardiologist and various tests likely including an angiogram and transoesophageal echocardiogram (TOE).

You will usually be asked to come into hospital the day before your procedure. On the day of the procedure you will be brought to the catheter laboratory (operating theatre) and will be given a general anaesthetic. A transoesophageal echo (TOE) probe will be inserted into your gullet to guide the procedure. Next a catheter (tube) will be placed in the vein in your groin. The Mitraclip will be directed from your groin into the right side of your heart. To access the mitral valve the Mitraclip will cross across the membrane between the two top chambers of the heart (interatrial septum) into the left atrium. Under guidance from the ultrasound pictures generated by the transoesophageal echo (TOE) probe, the Mitraclip will be deployed to bring the leaflets of the mitral valve together, hence reducing the leak on the mitral valve. Sometimes two or three clips are necessary to achieve a good result. In view of this the procedure usually takes 2-4 hours but can be longer if your case is technically difficult. After the procedure you will be taken to the recovery room whilst the effects of the general anaesthetic wear off and then will spend the next 1-2 days on the hospital ward before being discharged.

The clip often does not get rid of the mitral regurgitation (leak) completely but reduces the amount of leak present and has been shown in research trials to improve symptoms and quality of life.

Even though Mitraclip is considered a ‘keyhole’ procedure it is still a major operation and can be associated with complications. These complications vary according to each individual case and your Cardiologist will discuss these with you when you.


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