In India, Mitra Clip therapy offers hope for high-risk cardiac patients

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A very good innovation is reported in Indian medical science, especially in cardiology. Old aged patients having severe breathlessness in the resting stage, and their daily life and sleep after open heart surgery can now have a sigh of relief as a Mitra Clip therapy is available at a few specialised TAVR (Transcatheter Aortic Valve Replacement) hospitals in India.

It provides the patient with a new lease on life, significantly improves their quality of life with no surgical incisions or sutures, and gives immediate recovery. The patients get the ability to sleep comfortably and enjoy improved mobility, allowing them to walk and perform daily tasks with ease.

Mitral valve disease occurs when the valve doesn’t work properly, disrupting blood flow to the left heart chambers. The upper left heart chamber is called the left atrium. The bottom left heart chamber is called the left ventricle.

Mitral valve disease includes Mitral valve regurgitation. The mitral valve flaps, also called leaflets, may not close tightly. This causes blood to leak backwards. Mitral valve stenosis; the flaps of the mitral valve become thick or stiff, and they can fuse together. This narrows the valve opening, which reduces blood flow from the left atrium to the left ventricle. Treatment for mitral valve disease depends on the severity of the condition and whether it is worsening. Sometimes, surgery is recommended to repair or replace the mitral valve.

TAVR is a minimally invasive procedure that treats a type of heart valve disease.

Dr Prashant Dwivedi, Director & Incharge of the TAVR & Structural Heart Disease Program at Eternal Hospital, Jaipur claims that the Mitra Clip therapy offers hope for high-risk patients who are not candidates for surgery, providing a minimally invasive solution for treating mitral regurgitation. Dr Dwivedi who has performed three of the seven TMVR in Ring procedures done in India took this kind of challenging task in three cases recently.

A 77-year-old physician from Karnataka, underwent open-heart surgery in 2023, including CABG (Coronary Artery Bypass Graft) and surgical mitral valve repair with ring placement. However, three months post-surgery, he began experiencing severe breathlessness, even at rest, severely affecting his daily life and sleep, Dr Dwivedi said.

He further said, “Concerned about the ongoing mitral valve leakage, the patient consulted multiple cardiologists and cardiac surgeons in Hyderabad, Mumbai, and Delhi. Due to his recent open-heart surgery and additional health conditions such as lung and kidney issues, another open-heart procedure was deemed too risky. Hence he approached our hospital.”

After conducting a Transesophageal Echocardiogram and a CT scan of the heart, Dr Dwivedi determined that the patient was a suitable candidate for TMVR (Transcatheter Mitral Valve Replacement).

Led by Dr Samin K Sharma, Director of Mount Sinai Cardiovascular Clinical Institute & President, Mount Sinai Fuster Heart Hospital NY, USA, Dr Dwivedi successfully performed the TMVR Replacement without any incisions. The procedure took only one hour, and the patient was shifted to the ICU in an awake condition.

According to the expert doctor, the patient’s recovery was remarkably quick. The patient was able to stand and walk within 24 hours of the procedure and was discharged after two days of observation. This case highlights the potential benefits of TMVR for patients with mitral valve leakage, even in complex cases involving previous open-heart surgery and other health issues.

He and Dr Prem Ratan Degawat, Director of Mitral and Tricuspid Valve Programme performed the same procedure in two more cases in a high-risk 82 and 74 years old female patient- Sunita (name changed), an 82-year-old patient from Punjab, struggled with debilitating symptoms that made everyday activities challenging. She experienced discomfort even while sleeping and had to rely on 3-4 pillows to manage her symptoms. Rajni (name changed), a 74-year-old patient from Uttar Pradesh with multiple co-morbidities, including polycystic kidney disease, also faced severe breathlessness that affected her daily routine. Despite consulting multiple cardiologists, both patients were denied valve surgery due to their advanced age and high-risk factors, including repeated hospital admissions for heart failure over the past six months.

The Co-Chairperson Manju Sharma and CEO Dr Pracheesh Prakash of Eternal Hospital claimed it was a milestone with these advanced procedures, demonstrating its commitment to providing world-class infrastructure and experienced specialists for high-risk and complex cardiac treatments at affordable prices.