One out of five HFrEF patients has moderate to severe or severe MR. If left untreated MR initiates a cascade of events potentially leading to death (46.1% mortality with GDMT only). MR severity predicts progressively worse prognosis for HF patients. For many heart failure patients with MR, maximally tolerated medical therapy may not be enough. In many cases, surgery is also not a viable option for your heart failure patients with secondary MR. In such patients MitraClip procedure can be considered as an option to treat MR.
MitraClip is a minimally invasive procedure that can lead to a longer, better life for your HF patients with MR. It is a beating heart procedure—no cardiopulmonary bypass. It allows for real-time MR reduction assessment. There is the ability to reposition clip for optimal MR reduction. Patients are out of the hospital within 2-3 days on average. There have been two landmark clinical trials – EVEREST II and COAPT, basis which MitraClip has received USFDA approval to treat both inoperable and high-risk surgery patients with Degenerative and all patients with moderate to severe or severe functional MR along with maximally tolerated GDMT.
After MitraClip procedure patients are out of the hospital within 2-3 days on average. 9 out of 10 patients are discharged right to their home. Patients report sustained improvement in their quality of life. MitraClip has a well established clinical history with 16+ years of proven safety and clinical experience, more than 30,000 patients studied in clinical trials, more that 150,000 patients have been treated with MitraClip worldwide and 96.6% freedom from device-related complications at 12 months (secondary MR). Check your patients for one or more of these symptoms – Marked limitations on physical activity, Fatigue, Shortness of breath, Weight gain and Edema.
Medicine can help manage the symptoms of a mitral valve condition, but it is not designed to treat the underlying problem. Surgery for repair or replacement can be an effective long-term solution but is often not indicated for Secondary MR patients. Some of the key benefits that have been seen in the COAPT RCT for patients with functional MR are – 33% relative risk reduction in mortality over 36 months, 51% relative risk reduction in HF hospitalizations over 36 months and patients are 2.5x more likely to experience a large improvement in Quality of Life.
(Dr. Balbir Singh is Group Chairman – Cardiac Sciences, Pan Max & Chief of Interventional Cardiology and Electrophysiology, Max Hospital, Saket)