Minimally invasive procedure gives patients options when once there were none
Traverse City’s Edwin Mucha thought his shortness of breath probably meant more heart problems. He was right.
After visiting his cardiologist, he learned the problem was a leaky mitral valve in his heart. The good news was he could be helped without major surgery. As a former heart surgery patient, another surgery was not the best option.
“I would walk probably a half mile and I was getting weak, I had to stop,” Mucha said. “When they told me I had a leaking valve I was all for the procedure.”
Cardiothoracic surgeon Daniel Drake, M.D., said patients such as Mucha are seeing great results from the latest minimally invasive catheter-based technology that closes leaking mitral valves – a MitraClip®. The device is smaller than a paper clip and when properly placed restores integrity to the valve.
“It’s definitely a game changer. It’s primarily for elderly patients at high risk or prohibitive risk for cardiac surgery,” Dr. Drake said. “Our results have been categorically excellent.”
Dr. Drake and several members of the MitraClip team all traveled to Cedars-Sinai Hospital in Los Angeles for training on the procedure and implementation of the program. They did their first case in September. In addition to Dr. Drake, members include cardiologist and echocardiography specialist Anne Hepner, MD, FACC; interventional cardiologist Michael Howe, MD; interventional cardiologist Nicklaus Slocum, M.D., FACC, FSCAI; and echo cardiographer Karen Zimmerman. Other key members are anesthesiologists Brian Kiessling, M.D., and Matthew Martin, M.D.
Patients eligible for treatment begin in the hospital’s Structural Heart Clinic where Dr. Slocum is medical director. Once the patient’s symptoms are traced to a leaking mitral valve – which allows blood to flow in two directions during a heartbeat – treatment options are identified.
“It’s exciting for us because it’s a group of patients that didn’t have an option five years ago and now they have an option,” Dr. Slocum said.
Once a patient agrees to the procedure, they meet with each physician on the team before being scheduled to receive the MitraClip in Munson Medical Center’s Catheterization Lab, where catheter-based procedures are performed. The patient is put under general anesthesia and the interventional cardiologist guides the catheter from a groin blood vessel up into the heart and across into the area of the mitral valve. Once there, the teamwork between the heart medical specialties becomes crucial for success.
“The critical aspect of this is the echocardiography imaging,” Dr. Drake said. “If we can’t see, we can’t do the procedure.”
Once the echocardiography experts and interventional cardiologists have the catheter to the right place in the heart, the team puts the tiny clip in place. Sometimes more than one clip is needed to stop the leaking. Dr. Slocum said the typical two-hour procedure benefits from the team’s combined expertise to ensure the clip or clips have closed the valve. Patients stay 24 - 48 hours in the hospital for monitoring and return to see their cardiologist 30 days after the procedure.
“The feedback we hear from patients is that the procedure is simpler than they expected,” Dr. Slocum said. “They also have been impressed with how fast they get back to feeling more like themselves.”
Mucha said that was definitely true for him. He was out of the hospital within 24 hours. “It was like night and day before I went in and when I came out,” he said. “I walked up and down the hallway about five or six times at the hospital and there was no indication of shortness of breath.”
Dr. Drake said the MitraClip is just one of several new tools coming that will give cardiothoracic surgeons and cardiologists more options for their patients. Munson Medical Center’s cardiac research program allows hospital patients, cardiothoracic surgeons and cardiologists access to the latest procedures, medications, and techniques related to heart disease.
“We’ve been actively involved in clinical studies and I am convinced new techniques for the treatment heart disease will continue to rapidly expand in the future,” he said.