Understanding Transcatheter Mitral Valve Repair (TMVr)

The mitral valve sits between 2 upper and lower chambers in your heart. They are the left atrium and the left ventricle. The mitral valve lets blood with oxygen flow down from the atrium into the ventricle with each heartbeat. It closes between each beat. When the mitral valve doesn't work well, it causes problems with this flow. In some people, the valve can’t close tightly. Blood can then leak back up into the left atrium. This is called regurgitation. This can make you feel tired, get out of breath easily, or make your heart beat irregularly.

A transcatheter mitral valve repair is done to help fix this problem. Fixing the mitral valve can help you feel less tired, breathe easier, and have a regular heartbeat, which will improve your daily life.

During TMVr, a surgeon makes a small cut in the skin of your groin area. They put a thin tube called a catheter into a blood vessel there. The catheter is carefully guided through the blood vessels until it reaches your heart and the mitral valve. Through the catheter, one of these devices is sent to the valve to make it work better:

• Valve clip. The surgeon places a tiny clip on your mitral valve. It holds the edges of valve together. This will help the rest of the valve close better. It stops blood from leaking back up.
• Ring or band. The surgeon puts a small ring or band around your mitral valve. This supports the valve and makes it work well again.

Your healthcare provider will choose the best way to fix your valve based on what you need.

TMVr is usually done for people who can't have open heart surgery. It has some benefits over regular heart surgery:

• Lower risk. TMVr is a good option for people who may be at higher risk for problems with open heart surgery.
• Less invasive. This procedure uses a small incision, so it's safer and helps you recover faster.
• Shorter hospital stay. You won't have to stay in the hospital for as long after the procedure.

All procedures have some risks. The risks of TMVr include:

• Bleeding around the heart
• Damage to the heart, blood vessels, or valve
• The valve repair device falls off
• Narrowing of the valve
• Heart rhythm changes
• Infection
• Heart attack
• Stroke
• Need for open heart surgery
• Death

After the procedure, you'll be carefully watched. The medical team will check your heart rate and blood pressure. You may be sore where the catheter was put in. This should feel better in a few days. You may stay in the hospital for a few days. This depends on how you feel.

When you go home, you will need time to rest and recover. Make sure to:

• Take medicine as instructed. Your healthcare provider may prescribe medicines to help with pain, prevent infection, or keep your heart beating normally. Take them as your provider tells you. Tell them if you have any side effects.
• Rest and be careful. While you're healing, rest as needed. Don’t do hard activities or lift heavy things. Your healthcare provider will tell you when you can start being more active again.
• Go to your checkups. You will have appointments with your healthcare provider to see how you're doing. These visits are to make sure your heart is getting better. If you have any problems, tell your provider during these visits.

Call your healthcare provider if you have any of these:

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
• Pain, redness, swelling, bleeding, or fluid from the insertion site that gets worse
• Sudden change in weight

Call 911 if you have any of these:

• Chest pain
• Trouble breathing
• Sudden numbness or weakness in your face, arms, or legs
• Dizziness or fainting
• Shortness of breath or tiredness that doesn’t get better, or gets worse.
• Irregular heartbeats, a racing heart, or a feeling that your heart is skipping beats