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TMVR

What is TMVR?

Transcatheter mitral valve repair or TMVR is a way of treating mitral regurgitation (leaky mitral valve) and mitral stenosis (tight mitral valve), without undergoing conventional open-heart surgery. 

A thin, flexible tube (known as a catheter) is inserted in a vein of the groin. Under expert imaging, a cardiologist guides through a new valve, which is placed in the existing faulty mitral valve.

Transcatheter mitral valve repair is a minimally invasive procedure.

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    Frequently Asked Questions about TMVR

    The commonest cause of mitral valve stenosis (narrowing of the heart's mitral valve) is rheumatic fever, which is a strep-throat infection that happens in childhood. Rheumatic fever can scar the mitral valve, making it narrow. This narrowing of the mitral valve results in decreased flow of blood through it.

    Post mitral valve replacement surgery, patients with less-severe symptoms demonstrate an excellent survival rate. Studies show that survival is improved in patients with severe preoperative symptoms after the surgery. Life expectancy after mitral valve replacement is good if the procedure is done before the problem reaches an advanced stage exhibiting pronounced symptoms.

    A mitral valve replacement procedure may be necessary if your mitral valve is not working efficiently. Conditions of mitral valve stenosis and mitral valve regurgitation may need a mitral valve replacement. In mitral valve stenosis, valve leaflets become stiff or thickened, resulting in narrowing of vessels and reduced blood flow. In mitral valve regurgitation, the flaps of the mitral valve do not close tightly, resulting in backward leakage of blood.

    TMVR and MitraClip are used interchangeably for the minimally invasive procedure to fix leaky or stiff mitral valves. A thin tube is guided through a vein of the leg to reach the mitral valve of the heart. A small clip is implanted to the faulty mitral valve that helps in proper closing of the valve and prevents leakage.

    The whole process of TMVR has three steps: pre-procedure, procedure, and post-procedure recovery. The patients arrive on the morning of the procedure and undergo basic lab tests. The procedure may take 1 to 3 hours. Post-procedure, the patient is sent to a recovery area and later shifted to a room in the hospital.

    Because TMVR involves general anesthesia, you’ll be asleep during the whole procedure. A breathing tube is inserted before the procedure, which is removed afterward. TMVR is performed on a beating heart and a team of an interventional cardiologist, a cardiac imaging specialist, and a cardiothoracic surgeon is involved. You will be most likely discharged the next day.

    When done successfully, 90% to 95% of patients do not require reoperation for 10 to 20 years. Life expectancy is considered good post mitral valve repair. To keep up with sound health after the procedure and prevent infection, patients must take all postoperative precautions. They are also recommended to undergo annual echocardiography to assess valve function.

    In asymptomatic patients, the operative risk is approximately 1 in 1000 during a mitral valve repair surgery. In symptomatic patients, the risk remains well under 1%. Minimally invasive heart valve surgery (such as TMVR) has lowered the risks greatly in recent years. These techniques are not only safe for most people but also have a much-reduced recovery time.

    Open-heart mitral valve surgery (when the surgeon opens your chest to get to your defective heart valve) and minimally invasive TMVR (where a small implant is inserted in your heart through a catheter threaded through a vein) are done under anesthesia. You will be asleep during the operation and will not feel any pain or sensation.

    No, mitral valve repair does not shorten your life when performed expertly. As compared to mitral valve replacement, mitral valve repair provides better long-term survival, lower risk of complications, improved preservation of heart function, and in most cases, it also eliminates the need for long-term use of anticoagulants (blood thinners). All this increases life expectancy.

    If someone has mild-to-moderate mitral valve regurgitation without any pronounced symptoms, physicians do not suggest limiting their physical activity. When someone experiences symptoms of irregular heart rhythms or changes in heart size or function, they have to be cautious about their physical activity. But light activities such as moderate-paced walking can be done.

    Get a free second opinion from our specialist doctors or treatment advice, here.

    References

    1. https://www.medicinenet.com/survival_rate_of_heart_valve_replacement_surgery/article.htm
    2. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/mitral-valve-replacement-open
    3. https://mitraclip.com/fileadmin/Content/Downloads/Preparing_for_your_TMVr_Procedure.pdf
    4. https://www.moheartcenter.com/services/cardiovascular-surgery/tmvr/
    5. https://www.mercy.net/service/transcatheter-mitral-valve-repair-tmvr/
    6. https://my.clevelandclinic.org/health/treatments/17240-mitral-valve-repair#:~:text=What%20is%20the%20risk%20of,will%20affect%20your%20individual%20risk

    Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.

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