The mitral valve sits between the two chambers on the left side of your heart. Its two flaps, called leaflets, close when the lower chamber pumps blood out to your body. If they don't meet properly, some blood leaks backwards into the left upper chamber. This is called mitral regurgitation.
MitraClip is one brand of device used for mitral transcatheter edge-to-edge repair, often shortened to TEER. The clip holds part of the two leaflets together, and blood can still pass through the valve on either side of it. The aim is to reduce the leak and ease symptoms such as breathlessness. The existing valve stays in place, and some leaking may remain.
Call triple zero (000) for severe, worsening or persistent chest pain, or chest discomfort with breathlessness, sweating, nausea or pain spreading to your arm, jaw or back.
Do not wait for a routine appointment or drive yourself to hospital.
Before the procedure, the hospital gives you instructions about eating, drinking and medicines, including blood thinners and diabetes treatment. Don't stop or change a medicine unless the treating team tells you to. Tell the hospital team about swallowing difficulties, dental problems and any previous reaction to an anaesthetic.
The procedure usually takes place under a general anaesthetic, so you're asleep. A transoesophageal echocardiogram (TOE) uses a probe passed through your mouth into the oesophagus, the food pipe behind your heart. It gives the team a close view of the valve throughout the repair.
The doctor puts a thin tube called a catheter into a vein in your groin. X-ray and ultrasound images guide it into the right upper chamber, then through a small opening made in the wall into the left upper chamber. The clip is passed through this catheter to the mitral valve, without opening your chest.
Using the TOE images, the doctor positions the clip at the leaking part of the valve and closes it to grip the edges of both leaflets. The team checks how the leaflets meet and how much blood still leaks backwards before detaching the clip from the catheter. More than one clip may be needed.
The catheters and ultrasound probe are then removed, but the clip stays on the valve permanently. You'll move to a recovery area for monitoring.
A valve clip may be considered when the leak is severe and causes symptoms, particularly if heart surgery would carry a high risk. It isn't suitable for every leaking valve. Hospital cardiologists and a heart surgeon take into account how the leaflets move, how well your heart pumps and your other health conditions.
With primary mitral regurgitation, the valve leaflets or the structures supporting them are damaged. With secondary mitral regurgitation, changes in the heart's size or shape prevent the leaflets from meeting properly, often because of heart failure. The cause affects which treatment is likely to help.
An echocardiogram, or heart ultrasound, shows the leak and its effect on the heart. More detailed ultrasound pictures may be needed to check whether a clip can grip the leaflets while leaving enough room for blood to flow through.
Treatment starts with medicines for heart failure. Some people also benefit from a special pacemaker that helps the heart's lower chambers beat together. A clip may be considered if symptoms and a significant leak remain despite suitable treatment. Medicines usually continue after the procedure because the clip doesn't treat every part of heart failure.
Surgery may be recommended to repair the valve, or to replace it if repair isn't possible. For selected people whose risk from surgery is too high, a clip is another option.
Hospital staff check your heart rhythm and the puncture site in your groin. Bruising or soreness can occur, and the ultrasound probe may leave your throat sore. Your doctor will explain how long you need to stay in hospital and when you can return to driving and physical activity.
Follow-up appointments and echocardiograms check how much leaking remains and how your heart is working. Keep taking prescribed medicines, including any blood-thinning treatment. Tell your dentist about the clip and ask the treating team whether you need antibiotics before dental procedures.
Bleeding or damage to the groin blood vessel can need further treatment. Less common but serious complications include stroke, damage to the valve or heart, and infection. A clip can come loose, or the leak may remain too large. Some people need another procedure or surgery. Rarely, a complication can be life-threatening. Your hospital doctor will explain how these risks apply to you before you decide.
Before going home, ask whom to contact about increasing groin swelling, fever or worsening breathlessness, and which symptoms need emergency care.
Your GP or specialist can refer you to a Heartscope cardiologist to discuss a leaking mitral valve. The cardiologist reviews your symptoms and test results and can refer you to a hospital heart team if a valve procedure may help. The clinic can answer questions about the consultation.
Consultations are privately billed. If you're eligible, Medicare pays part of the consultation fee when you have a valid referral from your GP or specialist. The clinic will confirm the amount left to pay before the visit.
Hospital tests and the valve procedure are separate from the Heartscope consultation. The hospital or treating provider confirms those fees.
Heartscope cardiologists see patients at clinics in Melbourne and Queensland. If you have a referral, our team can confirm the location and appointment details.
View clinic locationsNo. The procedure is done in hospital. Heartscope cardiologists may be able to see patients with a valid referral from their GP or specialist, and can refer you to a hospital valve specialist when appropriate.
No. It repairs part of your existing valve by holding the leaflets together.
Usually not. Medicines may still be needed for heart failure, blood pressure or an irregular heartbeat. Your doctors will review the treatment as your recovery progresses.
Tell the imaging provider about the clip before an MRI. Keep your implant card so staff can check the exact device and the scanning conditions that apply.
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