Transcatheter Procedures for Mitral Valve Disease

For some people with mitral valve regurgitation or mitral valve stenosis, specialists at NYU Langone’s Heart Valve Center may recommend a nonsurgical procedure in which doctors use a catheter—a thin, hollow tube—to deliver a device that can improve the valve’s function.

Transcatheter Mitral Valve Repair

If you have mitral valve regurgitation, your NYU Langone doctor may recommend transcatheter mitral valve repair using a small clip, known as the MitraClip®. The Heart Valve Center is the most experienced and busiest MitraClip® program in the Northeast region.

In this procedure, which is performed while you are asleep, surgeons insert a catheter into the femoral vein in the leg and guide it to the left atrium of the heart. After the catheter is inside the atrium, doctors move a small, polyester-covered clip through the catheter and position it above the leak in the mitral valve.

Surgeon Performs a Transcatheter Procedure

The clip grasps both of the mitral valve’s leaflets, enabling them to close better by reducing any gaps or floppy portions. This helps reduce the backward flow of blood through the valve while allowing blood to flow from the atrium to the ventricle.

When the procedure is finished, the catheter is removed. This procedure does not require incisions or the use of the heart–lung machine, and most people go home the day after the procedure. Our patients recover more quickly and have better outcomes than the national average, and 97 percent of our patients experience a reduction in mitral regurgitation.

Transcatheter Mitral Valve Replacement

Transcatheter mitral valve replacement (TMVR) is a catheter-based treatment that relies on accessing the femoral vein through an incision in the groin. With the help of advanced imaging, the doctor guides a new valve into the heart and anchors it in place. Once positioned, the new valve takes over the work of the diseased valve.

TMVR is also an option for people who are experiencing mitral stenosis or mitral regurgitation in a previously replaced valve. The Heart Valve Center team can replace the bioprosthetic mitral valve, pushing it to the side and placing a new valve within the metal frame. If the mitral regurgitation or leak is around the prosthesis, instead of a replacement, the team can potentially seal or plug the defect through a catheter-based procedure. The majority of patients return home the day after the procedure.

Before TMVR, open heart surgery was the only option for people who need mitral valve replacement. The transcatheter approach makes TMVR an option for some people who are not ideal candidates for open heart surgery.

Mitral Balloon Valvuloplasty

Mitral balloon valvuloplasty is used for some people with mitral valve stenosis due to rheumatic heart disease. During this procedure, which requires local anesthesia and, sometimes, sedation, surgeons open the stiffened mitral valve with a special balloon.

Using fluoroscopy, a series of real-time X-rays that allow the doctor to view the procedure on a computer screen, the physician inserts a catheter into a vein in the groin and up to the heart. The catheter contains a balloon that’s expanded inside the mitral valve to separate its stiffened leaflets. The catheter and balloon are removed from the body through the vein.

Many patients go home the day of the procedure, and recovery is typically very quick.

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