Mitral Valve Disorders

Mitral Regurgitation

Healthy mitral valves act as one-way gates that keep blood moving forward through the heart. Mitral regurgitation happens when the valve leaflets do not close completely. This lets blood leak backward from the main pumping chamber into the lungs. As a result, the heart must work harder, and the backup of blood can cause shortness of breath.

If left untreated, mitral regurgitation can become a serious, progressive and life-threatening condition. It can damage the heart muscle and increase the risk of arrhythmia, stroke and heart failure. Medications can help manage symptoms but can’t stop the disease from getting worse.

It's important to see a doctor if you notice any of these signs:

• Shortness of breath
• Extreme fatigue
• Heart palpitations
• Lightheadedness
• Swelling in the feet or legs

Severe, symptomatic mitral regurgitation can be treated with open-heart surgery or minimally invasive procedures using a catheter, such as mitral valve transcatheter edge-to-edge repair (Mitral TEER). The UCLA Health heart team made of cardiologists, cardiomyopathy specialists and cardiac surgeons will evaluate each patient and develop the best medical and treatment plan with the patient. 

What Is Mitral TEER?

Mitral TEER is a minimally invasive procedure sometimes called a Mitral clip procedure. It is performed under general anesthesia. The doctor makes a small incision in the groin to access the femoral vein. A thin tube, called a catheter, is threaded into the heart using advanced cardiac imaging. The catheter delivers the clip to the mitral valve. Once in place, the clip cinches the leaflets together thereby reducing backflow and helps the heart pump more efficiently. Mitral TEER has been FDA-approved since 2013 and is the most effective treatment for patients who aren’t candidates for traditional surgery.

For some patients, especially those with heart failure, Mitral TEER may be the best option when medications are not enough to control mitral regurgitation.

Dr. Calfon-Press talks about MTEER procedure 

Exceptional Outcomes and Proven Success

Studies and patient registries show Mitral TEER improves symptoms and quality of life and reduces heart failure hospitalizations, even in very ill patients.

A 2013-2014 registry of 564 patients reported a 91.8% success rate, defined as reducing regurgitation to “moderate” or less. The 2018 COAPT study showed Mitral TEER with medical therapy is better than medical therapy alone for functional mitral regurgitation, leading to FDA approval for this use. 

What to Expect With Mitral TEER

Once patients are referred for evaluation, appointments are scheduled to meet with the cardiologist at UCLA Health. If not already done, a transesophageal echocardiogram (TEE) is done to determine if Mitral TEER is possible. If Mitral TEER is recommended, the procedure date is then set. Many patients are discharged one to two days after the procedure.

On the day of Mitral TEER, patients check in at the hospital. After preparation, the procedure is performed. The Mitral TEER procedure usually takes about two hours under general anesthesia. Patients are monitored for valve function and medications are adjusted as needed. Most patients stay in the hospital for one to two days. Some notice symptom improvement right away as circulation improves. Once stable, follow-up appointments are arranged at one month and one year, including echocardiograms.

UCLA Health is currently evaluating patients who may need Mitral TEER. For more information or to schedule an evaluation, please call the number below.

UCLA’s team approach

UCLA’s dedicated mitral valve repair team works in close partnership with patients, their families and referring physicians to coordinate a an individualized care plan designed to offer the best outcomes. A bi-monthly conference allows access to the entire mitral valve repair team in one visit and location. Individuals are encouraged to ask questions and a detailed review of each patient’s clinical prognosis and personal preferences is discussed. The team offers a same-day consensus and joint recommendation for the most effective treatment strategy.