Transcatheter Mitral Valve Edge to Edge Repair

Transcatheter Mitral Valve Edge to Edge Repair (MitraClip and Pascal)

Your heart has several valves that help control blood flow. One of these is the mitral valve, which sits between the left atrium and left ventricle. If this valve becomes leaky—a condition known as mitral regurgitation—blood can flow backward, placing extra strain on the heart and lungs. This can lead to symptoms like breathlessness, fatigue, palpitations, or swelling in the legs.

This is a minimally invasive alternative to open-heart surgery. It is often recommended for people who are not suitable for traditional surgery due to age or other health conditions. The procedure uses a small device called a clip or clasp to reduce the leak in the valve and improve heart function.

What happens after the procedure?

You will be monitored in a recovery area of ICU as you wake up. Most patients stay in hospital for two to three nights.

Please arrange for a family member or friend to collect you from hospital and stay with you overnight. You should not drive or make important decisions for 24 hours after having a general anaesthetic.

If you have any concerns about the anaesthetic, please speak with your doctor before the procedure.

How is the procedure performed?

  • You will be given a general anaesthetic, so you will be asleep and pain-free during the procedure.
  • A breathing tube will be inserted to support your breathing.
  • A catheter (a thin, flexible tube) will be inserted through a vein in your groin and guided to your heart.
  • An ultrasound probe will be placed down your throat (transoesophageal echocardiogram) to help your doctor see the mitral valve clearly.

The Mitra Clip device is delivered through the catheter and positioned to clip the leaking parts of the valve together. More than one clip is usually needed. The catheter crosses from the right side of the heart to the left through a thin wall called the atrial septum, which may leave a small hole that usually closes on its own. Very occasionally, this hole is closed with an ASD occluder.

Once the clips are in place, the catheter is removed, and the entry site is sealed.

What are the risks?

  • Minor bruising or bleeding at the catheter site
  • Temporary abnormal heart rhythms
  • Sore throat from the breathing tube or ultrasound probe
  • Swelling or haematoma at the groin or arm

Less common risks

  • Stroke, which may cause long-term disability.
  • Blood clots (embolism), which may require blood thinners.
  • Accidental puncture of the heart, which may need surgery.
  • Death, though this is rare.

Rare risks

  • Persistent abnormal heart rhythm requiring electrical correction.
  • Surgical repair of the catheter entry site or blood vessel
  • Kidney damage
  • Difficulty accessing the vein—may require switching to another site.
  • Infection requiring antibiotics.
  • Heart attack
  • Increased lifetime exposure to radiation
  • Air embolism
  • Nerve damage in the leg
  • Emergency heart surgery due to complications
  • Skin irritation or injury from radiation
  • Allergic reaction
  • Detachment of clips and clasps

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