Mitraclip - a clip to reduce the valve leakage of mitral valve

As artificial intelligence and machine learning drive innovation in the medical field, a new revolution is brewing in the form of minimally invasive surgical procedures. One such procedure is MitraClip, an FDA-approved device that aims to treat a common heart condition known as mitral regurgitation.

Mitral regurgitation occurs when the mitral valve, which separates the left atrium and the left ventricle, does not close properly, leading to blood leaking back into the left atrium. Over time, this can result in an enlarged heart and heart failure. Traditionally, surgery to repair or replace the mitral valve has been done through open-heart surgery, which is a major procedure with a significant recovery time. However, MitraClip offers a less invasive option, with potential benefits including a shorter hospital stay, quicker recovery time, and decreased risk of complications as

sociated with open-heart surgery.

So, how does MitraClip work? During the procedure, a small incision is made in the groin and a catheter is inserted through a vein to the heart. The MitraClip device is then guided to the mitral valve and clipped onto the valve to improve its function. The procedure can be performed under conscious sedation or general anesthesia and typically takes a few hours.

The benefits of MitraClip are not just limited to the patient experience. The device also offers potential cost savings for healthcare systems. One study found that the procedure reduced the rate of hospital readmissions and was cost-effective compared to traditional surgery over a five-year period.

MitraClip has been tested in clinical trials and has shown promising results. In the COAPT trial, patients with moderate to severe mitral regurgitation who were treated with MitraClip had a lower rate of hospitalizations and deaths compared to those who received medical therapy alone.

However, MitraClip is not suitable for all cases of mitral regurgitation. Patients must undergo a thorough evaluation to determine if they are a good candidate for the procedure.

In conclusion, MitraClip is a minimally invasive option for treating mitral regurgitation that offers potential benefits for patients and healthcare systems. As technological advancements continue to drive innovation in the medical field, more procedures like MitraClip may be developed to provide improved outcomes for patients.

TAVI (Transcatheter Aortic Valve Implantation)

1. Transcatheter Aortic Valve Implantation (TAVI)

The treatment of choice for severe aortic stenosis in elderly is now transcatheter aortic valvular implantation. This procedure involves implanting a balloon expandable stent inside the diseased aortic valve.

2. Preoperative Assessment

To determine whether this procedure is suitable for a particular patient, a multidisciplinary team of cardiologists and cardiac surgeons, Anesthetists assesses the individual's medical history, physical examination, laboratory results, imaging studies, and any previous surgical procedures. More critical part of assessment is CT aortogram

3. TAVI Procedure

Once the decision to proceed with TAVI is made, patients are taken into cathlab, where the procedure is done under conscious sedation or local anesthesia. (There is no need for general anesthesia or endotracheal intubation). Femoral artery is punctured, a small sheath is placed. Next, a guide wire is advanced through the femoral artery into the left ventricle. Finally, the balloon-expandable valve is introduced through the femoral artery and positioned at the level of the aortic annular ring and valve is deployed by inflating the balloon. once deployed, balloon is deflated and taken out. Femoral sheath removed and puncture site is closed using closure device

4. Postoperative Care

After the procedure, patients are monitored closely in the intensive care unit for few hours. Blood pressure, pulse oximetry, electrocardiography, and temperature are measured every few minutes. Patients typically are made to ambulate within 6-8 hours, remain in hospitalized overnight and are usually able to return home within one to two days after the procedure.

Dr. Srinivasa Prasad's Professional Statement

Dr. Srinivasa Prasad B V has good experience in Interventional cardiology and he is skilled to perform invasive diagnostic and therapeutic procedures like Coronary angiogram, coronary angioplasty including bifurcation, ostial, CTO - with or without CrossBoss-stingray, FFR, OCT, IVUS, Cath study, IABP, Pacemaker – temporary/ permanent, ICD, CRT, ASD Device closure, PDA device closure, VSD device closure, RSOV device closure, Transcatheter aortic valve replacement (TAVR), Transcatheter Mitral Valve Replacement (TMVR), paravalvular leak device closure, left atrial appendage occlusion, alcohol septal ablation, PDA stenting, Balloon atrial septostomy, Balloon Mitral Valvotomy, Balloon Pulmonary Valvotomy, Balloon Aortic Valvotomy, Impella assisted Complex angioplasty, Carotid stenting and so on