The mitral valve is a small but very important element of the heart that helps to ensure blood is flowing in the correct direction throughout the body. If it becomes damaged or weakened, due to conditions such as regurgitation (a leaky valve) or stenosis (a narrowed valve), it may need to be replaced.
Transcatheter mitral valve replacements (TMVR) is just one of the many forms of delicate and complex heart valve repair and replacement procedures that our board-certified cardiothoracic surgeons frequently perform at CTVS.
Mitral valve replacement is traditionally performed by open-heart surgery, which has certain risks associated with it. New technology, however, provides our skilled surgeons the opportunity to replace the valve via a catheter through small incisions, which may prove beneficial for some patients.
“Although TMVR is still at the clinical trial stage, it has been routinely effective for those patients who are at high-risk for open-heart surgery,” says CTVS cardiothoracic surgeon and specialist Dr. Faraz Kerendi. “The catheter allows us to interchange the new replacement valve in a much more minimally-invasive manner.”
Dr. Kerendi explains the procedure and weighs in on its benefits and risks here:
What is a transcatheter mitral valve replacement (TMVR)?
With TMVR, the mitral valve in the heart is replaced with a catheter-based valve which is delivered via a small incision between the ribs or a puncture in the groin rather than traditional open-heart surgery. This procedure is required to correct the mitral valve when it is weakened from regurgitation or stenosis. The new valve implants are either of a synthetic or biological nature generated from other living tissue.
Who is the best candidate for TMVR?
A patient would be considered for TMVR if they are deemed to be high-risk for open heart surgery, and it is felt that they would benefit from a minimally-invasive approach. Those considered high-risk might be patients who are older or have other serious chronic medical issues.
Because these valves are in clinical trials, only those with appropriate anatomy and medical conditions can be considered for TMVR at this time.
What are the benefits and risks of TMVR?
One of the primary benefits of TMVR is that it offers a faster recovery and return to regular activity due the minimally-invasive nature of the procedure over open-heart surgery.
The risk is that because it is still in the trial phases and not yet FDA-approved, the long-term durability and effectiveness are unknown at this point. Also blood thinners are often needed for at least six months following TMVR to prevent the development of dangerous blood clots.