TMVR

You have four valves present in the heart that allow blood to flow in the right direction. The mitral valve is one of the four valves that lets blood flow from one heart chamber (left atrium) to the other heart chamber (left ventricle). In certain mitral valve diseases, like mitral regurgitation, degenerative valve disease, or mitral stenosis, the valve doesn’t function properly, limiting adequate blood circulation. The dysfunction of any of the four valves puts an extra burden on your heart to pump and supply blood to the entire body.

If there are any leaks in the leaflets (flaps) of the mitral valve, the blood may flow backward to the valves after they are closed because of leaks. This condition of the backward flow of blood in the valves is known as mitral regurgitation. Another valve disease that narrows the mitral valve, restricting the flow of blood from the atrium to the ventricle is known as mitral stenosis. These mitral valve diseases or leakiness can be fatal if left untreated and requires replacing the diseased valve with a healthy valve.

Q. What is Transcatheter Mitral Valve Replacement (TMVR)?

Transcatheter Mitral Valve Replacement is an implantation procedure of a healthy mitral valve mainly indicated for patients who cannot undergo open heart surgery because of certain risks, like advanced age or multiple pre-existing chronic diseases.

The procedure is used to replace a leaky mitral valve with a healthy valve through a catheter-based procedure without opening the heart. Patients suffering from mitral valve diseases, like mitral regurgitation, mitral stenosis, or both plus can’t tolerate open heart surgeries are the ideal candidates for transcatheter mitral valve replacement (TMVR).

Also Read: Transcatheter Aortic Valve Implantation (TAVI)

Q. Why is Transcatheter Mitral Valve Replacement done?

Transcatheter mitral valve replacement is done as an alternative treatment for people who have a leaky and damaged mitral valve but surgical treatment can be risky, and may cause severe complications, like heart failure or death.

Elderly patients are also unable to tolerate open heart surgeries because of advanced age or multiple diseases like diabetes, kidney disease, or hypertension, putting them at risk for heart surgery. Hence, in these cases, minimally-invasive procedures to replace the damaged valve become an ideal option. Transcatheter mitral valve implants can be made of artificial valves, annuloplasty rings, or other native mitral valve ailments.

Q. What is the procedure for Transcatheter Mitral Valve Replacement?

Here is how transcatheter mitral valve replacement is performed:

• The patient will be admitted to the hospital one or two days before the surgery.
• General anesthesia will be administered to the patient before surgery.
• Next, a small incision will be made in the patient’s groin.
• A guidewire and a catheter (small, hollow tube) with an attached clip will be inserted at the place of incision, and will gradually move to the heart.
• When the catheter reaches the heart, the guidewire is removed.
• The arms of the clips will be opened and attached to the leaflets of the mitral valve. Next, the clips will be closed to connect the leaky flaps of the mitral valve together.
• After clipping the leaky mitral valves, the catheter is slowly removed from the body.
• The patient may need to stay in the hospital for one or two days after the mitral valve implantation. Regular follow-ups should be done to examine the functioning and progress of the implant and the patient’s condition.