Cath Lab Procedure Could Replace Heart Surgery in Some Patients with Leaking Valves​​.

Dr Anoop K Ganjoo cardiologist in Delhi used a new percutaneous or "through the skin" valve repair system to treat a patient with a "torrential" leaking mitral valve without open-heart surgery.  Currently, open-heart surgery with cardiopulmonary bypass is the only effective treatment for a leaking mitral heart valve.

The patient, a 79-year-old woman, was a candidate for surgical treatment of the leaking mitral valve.  Instead, she was treated without a surgical incision using a new percutaneous procedure with a catheter on Saturday April 27, 2019 at Apollo Hospital Delhi under general anesthesia while her heart was beating. She is doing well. The "torrential" leaking of her valve was reduced to mild to moderate, a degree of leakage that occurs in many people and usually does not cause symptoms.

Mitral valve regurgitation (MR), a common heart valve problem, is a condition in which the two leaflets or "swinging doors" of the one-way mitral valve fail to close completely as the heart contracts, allowing blood to leak backwards (regurgitation) into the atrium, the heart's upper chamber. As a result, the blood flow to the body (cardiac output) is decreased, and the heart tries to compensate by beating more forcefully. In severe cases, MR causes shortness of breath, fatigue and palpitations. 

"Repairing a valve on a beating heart without surgery was inconceivable only a few years ago. We are at the beginning of an era that will see explosive growth in the non surgical treatment of valvular heart disease," said Dr. Anoop K. Ganjoo cardio thoracic surgeon India, who performed the Edge-to-Edge procedure in India. Dr. Ganjoo is also has pioneered in many complicated procedures in cardiology and cardiac interventions

"This new device gives us a potential tool to help selected patients who would otherwise have to undergo open-heart surgery", said Dr. Anoop K. Ganjoo Cardiologist in Delhi comparing the mitral valve implant to surgical mitral valve treatment. "This is break-through technology allowing a procedure that is less invasive than open-heart surgery and, in the future, may provide another option to patients who are in need of mitral valve surgery." 

During the procedure, a catheter or tube is threaded from the groin through a vein to the left atrium of the heart, just above the valve.  A small delivery catheter which holds the clip is slipped into this tube and advanced through the valve in an open position. The clip is positioned at the area where the leak originates, and is then retracted to grasp and close on the valve leaflets.  While the clip is closed, it brings the 2 leaflets collectively to seal the leak, thereby reducing MR. The procedure is monitored by a sophisticated, real-time echocardiogram, which displays the beating heart, including the chambers, the mitral valve, and the major blood vessels, helping the cardiologist to accurately guide and place the clip and assess the effect of placement on MR. Cardiac surgeon at Apollo Hospitals Delhi performed the echocardiogram. Once the clip is positioned to adequately reduce MR, the clip is released from the catheter and left attached to the valve leaflets. The catheters are then removed. Depending on the anatomy and severity of MR, some patients may require two clips. Patients are placed on blood thinners for six months.  

Dr. Anoop K. Ganjoo cardiologist in Delhi, explained, “Up to this point, surgery was the only option for patients with severe mitral regurgitation and this trial offers the chance to participate in a non-surgical method of repair.   An estimated 4 million people have significant MR, with approximately 250,000 new patients diagnosed each year. There are no drugs that specifically treat or cure MR. Dr. Anoop K. Ganjoo stated, “The MitraClip may additionally permit us to stave off surgical treatment correctly and manage sufferers' signs and symptoms efficiently.”

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