The Heart Team evaluates all your medical records and tests to determine if you may be a good candidate for MitraClip. If you are not an ideal candidate for traditional mitral valve surgery, then MitraClip is an excellent option.

Some conditions increase the risk of open heart surgery, including:

• age
• heart failure
• frailty
• dementia
• prior cardiac surgery or radiation to the chest
• other serious medical conditions that increase the risk of surgery

It is also very important to determine if your mitral valve can be clipped. A transesophageal echocardiogram (TEE) is used to help your doctors determine if your mitral valve anatomy is suitable for the MitraClip.

Numerous clinical trials have been performed studying the MitraClip.

Primary (Degenerative) Mitral Regurgitation

In people with primary MR who are not ideal surgical candidates, TMVR significantly improves your symptoms and reduces the risk of being admitted to the hospital for heart failure. These results are durable and were sustained out to 5 years. 

Learn more about MitraClip

As soon as you are referred for an evaluation, you can expect that:

• We will mail you a welcome packet that also includes a list of items to bring to your visit including:
  • Patient information questionnaire (Please try and fill out prior to the visit)
  • Current medication list including dosages and frequency
  • Insurance card(s)
  • Photo ID
  • A list of questions that you or your family may have
• We will obtain and review all available medical records including any important imaging related to the evaluation
• If you have secondary mitral regurgitation, you may also be referred to our Advanced Heart Failure service for management

We encourage you to bring family, friends, or anyone you would like to come to the visit along with you.

A typical visit includes:

• Frailty testing to assess your ability to recover following valve repair or replacement
  • Hand grip strength assessment
  • 5-Meter walk test
  • 6-Minute walk test
• Heart Team Evaluation to discuss your options for treatment including an assessment by an:
  • Interventional Cardiologist
  • Cardiac Surgeon
  • Heart Failure Physician (if needed)
• Additional tests may be required to complete your evaluation including:
  • Transesophageal Echocardiogram (TEE)
    • This allow us to assess the cause and severity of your MR and options for surgery or TMVR
  • Coronary Angiogram:
    • This test is a procedure that looks for blockages in the arteries that supply blood to your heart
    • It involves inserting a small tube (catheter) into a blood vessel in your arm or leg and guiding it into your heart.
    • We then inject X-ray dye through the tube to assess the blood flow to the heart

What happens if I have a blockage?

• Treatment is different for every individual and may include:
  • Medicines to reduce any symptoms or worsening of the blockages
  • Stenting of the blockage
  • Bypass surgery
• Your Heart Team will discuss your options for treatment with you which may also determine how your mitral valve is fixed

After the evaluation, the Heart Team will help you to determine your options for mitral valve repair or replacement and the timing of the procedure

• Activity
  • It is OK to maintain your current level of activity including exercise
  • If you develop symptoms, then STOP and rest
  • If you develop any new symptoms (including weight gain), then please inform your physician
• Diet
  • Continue to eat a healthy, low salt diet
• Make a Recovery Plan
  • It is very important to plan for the following:
    • Who will take me home?
    • Who will stay with me the day I am discharged?
    • Do I have help for preparing meals, driving, or other household chores during the first few days following the procedure?
  • The day before the procedure
    • You likely will be asked to have your blood drawn to have updated labs
    • DO NOT EAT ANYTHING AFTER MIDNIGHT OR THE MORNING OF THE PROCEDURE
      • It is ok to have small sips of water to take your morning medications

• The procedure is performed at Rochester General Hospital
• You will be given specific instructions on where to go on the day of the procedure
• You will meet the anesthesiologist prior to the procedure
  • TMVR (Mitraclip) requires general anesthesia which requires a breathing tube that will be removed at the end of the procedure
  • TEE is also performed to help your physicians implant the MitraClip device
• The procedure takes about 2 to 3 hours to perform
• As with any medical procedure, there are risks and anything can happen.
  • The most serious risks of TMVR include: death, stroke, vascular complications, and bleeding events requiring transfusion and/or immediate surgery

The recovery time is fast. Your symptoms may be better shortly after your procedure. You will recover in our post-procedural recovery area and will ambulate within 2 hours of the procedure.

• Most patients can be discharged the same day of the procedure or stay overnight with discharge the following morning
  • If you stay overnight, then you will be assigned a bed on one of our cardiac hospital floors
• Our criteria for discharge is:
  • You do not have any bleeding issues at the sites used for vascular access
  • You can ambulate without any major limitations
  • You feel well and have a recovery plan!
• We will give you detailed instructions about any restrictions and new medications following the procedure
  • Most patients can resume full activity including driving 2 days after the procedure
• Follow-up
  • You will see your primary cardiologist or a provider in the Center for Advanced Valvular and Structural Heart Disease within 1-2 weeks of the procedure
  • You will undergo an echocardiogram at 30 days and 12 months and either be seen in our Valve Clinic or contacted for a telephone follow-up visit