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New, innovative transcatheter mitral valve repair at Royal Brompton & Harefield Hospitals Specialist Care

18 Sep 2019 8:59 AM
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The transcatheter mitral valve repair programme at Royal Brompton and Harefield hospitals, also called TMVR, is one of the world’s most experienced and comprehensive. Dr Robert Smith has treated in excess of 150 leaky mitral valves with innovative MitraClip therapy. So what’s it all about?

 

What can go wrong with the valves of the heart

Human heart valves are extraordinary structures, far more complex than you might imagine. The mitral valve is particularly complicated with thin valve leaflets that attach to the heart wall with lots of string-like chords. Like all heart valves it opens and closes many, many times a day, millions of times over a lifetime, and like every moving part, it’s prone to wear and tear.

Mitral regurgitation, MR, is a risk when you’re older, have coronary artery disease, a birth defect, or an underlying heart muscle issue. When the mitral valve’s two leaflets don’t completely shut, blood flows backwards at high pressure through the valve into the heart’s left atrium, which means the heart has to work much harder to send blood around the body. The result is fatigue, shortness of breath and worsening heart failure, pressure on the pulmonary vessels, and in severe cases lung fluid congestion.

 

How to treat a leaky mitral valve

Mitral regurgitation is usually treated via open-heart surgery, but sometimes the risks are too high and other times the regurgitation is ‘functional’, down to a weak heart muscle. At times like this, the MitraClip is often the perfect solution. This is known as a ‘transcatheter procedure’ and it’s a lot less invasive than conventional surgery, accessing the heart through a small, neat incision in the groin.

Dr Robert Smith, consultant interventional cardiologist, runs the most experienced MitraClip team in Britain. The device, created by Abbott Vascular, is a little clip that attaches to the mitral valve, treating regurgitation by letting the mitral valve close better and helping restore normal blood flow through the heart.

A radiographer is present during the procedure to provide x-ray images to guide the cardiologist, and a second cardiologist guides a transoesophageal echocardiogram (TOE), an ultrasound probe that checks the heart’s structure and function.

 

Instant results

The MitraClip reduces mitral regurgitation instantly, and the improvement is often obvious to the patient as soon as they wake from the anaesthetic. After 48 hours, 90-95% of patients see a significant improvement in their symptoms. A hospital stay of a few days is all that’s needed for recuperation, much faster than open-heart surgery, and in the long term, the treatment has been proven to cut the number of hospital visits for heart failure.

 

A specialist MitraClip team

The highly experienced multidisciplinary team at Royal Brompton and Harefield hospitals are world leaders in transcatheter mitral clip treatment. In fact, they’re by far the most experienced unit in the UK, having carried out more than 230 MitraClip procedures.

As a private patient, you can access the entire team, including Dr Smith. He works closely with a number of world-leading surgeons, cardiologists, anaesthetists and nurses, including a specialist MitraClip nurse who second-operates with Dr. Smith. She is a clinical nurse specialist, co-ordinating all MitraClip patients, by liaising with them and booking them in. Patients have direct contact with her in the run-up to the procedure, and can speak to her directly.

 


 

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