Improving How We Perform Heart Surgery

An innovative heart valve repair procedure that Saint Joseph Hospital pioneered in Lexington is now available to more patients.

Saint Joseph Hospital has long offered the MitraClip™ procedure as a less invasive alternative to open-heart surgery for certain patients with mitral valve regurgitation (MR). This condition occurs when the leaflets of the mitral valve — one of four valves of the heart that control the one-way flow of blood through the organ — don’t form a tight seal when they close, allowing blood to leak backward into the left atrium. Degenerative MR happens when the leaflets become weakened, and functional MR is when the valve is stretched.

“Left untreated, mitral valve regurgitation inevitably results in heart failure, which manifests as shortness of breath,” said Nezar Falluji, MD, medical director of the structural heart program at Saint Joseph Hospital and system vice president for the cardiovascular service line at CommonSpirit Health. “Furthermore, mitral valve regurgitation can enlarge the left atrium, which raises an individual’s risk of atrial fibrillation. That, in turn, increases stroke risk.”

Saint Joseph Hospital has performed the MitraClip procedure for most of the past decade for functional MR (as part of the COAPT trial) and for degenerative MR. In 2020, the MitraClip procedure became available for all individuals with functional or degenerative MR who are appropriate candidates, thanks to federal regulatory approval.

Clip In, Leak Out

Interventional cardiologists perform the MitraClip procedure in the cardiac catheterization lab at Saint Joseph Hospital. With the patient under general anesthesia, the interventional cardiologist inserts a catheter into the patient’s groin and sends it through veins to the heart. Using real-time echocardiogram imaging to guide the way, the physician sends the MitraClip — a tiny metal clip — through the catheter and attaches it to the mitral valve. The clip helps the valve close properly. The procedure takes one to two hours, and most patients go home the next day.

“MitraClip changes the lives of patients who are incapacitated by shortness of breath and have to limit their daily activities,” Dr. Falluji said. “Placement of the clip in the proper patients can cause a dramatic improvement in quality of life, reduce hospitalizations and, in people with functional regurgitation, reduce cardiovascular-related death.”

To learn more, visit CHISaintJosephHealth.org/mitraclip-procedure.

A version of this article originally appeared in the Summer 2021 edition of Spirit of Health. For more stories like this one, subscribe to Spirit of Health magazine today.