“At night, he would sleep fitfully, with his heart-pounding. He would then jerk awake gasping for breath. He had an acute cough which would get worse when he was asleep,” his wife says. His doctor recommended blood tests and an electrocardiogram as he suspected a heart problem. Tests revealed that 79-year-old Narendra (name changed) was suffering from severe Mitral Regurgitation (MR) or abnormal reversal of blood flow from the left ventricle (LV) of the heart to the left atrium (LA). This is not a story, but reality. In the last three decades, India has witnessed an accelerated rise in the prevalence of cardiovascular diseases.
According to a Lancet study, deaths due to cardiovascular diseases (CVDs) rose from 1.3 million in 1990 to 2.8 million in 2016 in India. Even as, there are conventional treatments available such as medicines or open-heart surgery to treat the condition, subject to the severity of symptoms, there are several limitations. While, medication may reduce the symptoms, they cannot fix the valve. Similarly, open heart mitral valve surgery is an effective and well-proven way to treat the MR, but not all patients are suitable for it. If a patient has other medical problems, open heart surgery can be risky. However, with advanced medical technology, there are evolved treatment options like transcatheter mitral valve repair therapy to help patients with MR. It is the safest alternative for patients suffering from MR who are either old or have a weak heart and a history of non-cardiac conditions involving kidneys, lungs or brain.
Understanding mitral regurgitation better
MR is a condition in which the heart’s mitral valve does not close tightly, allowing blood to flow backward in the heart. If the regurgitation or leakage is significant, blood cannot pass through the heart or to the rest of the body efficiently. This results in breathlessness, cough, heart palpitations, fatigue and swollen legs. MR can be related to age, a birth defect, or a history of heart disease. If leakage is significant, it can cause blood clots to form. When clots travel from the heart to the brain, it can lead to a stroke or heart attack. However, if left untreated, the condition can lead to several cardiac problems such as heart failure, atrial fibrillation and pulmonary hypertension.
Technology comes to rescue
Credit it to evolving technologies, patients no longer have to endure long term stays or recurrent visits to hospitals. Minimally invasive procedures such as mitral valve repair offer a safe and effective alternative option for MR patients who are at prohibitive risk for conventional mitral valve surgery. Moving away from the risky open-heart surgery, a doctor inserts a small clip into a vein in the groin using a needle stick. From there, it is threaded through the vein and advanced to the right side of the heart. Then it is sent across the septum (which separates the heart’s upper chambers), from the right side to the left side of the heart. Under ultrasound guidance, the surgeon then directs the clip to grasp the mitral valve. To ensure an optimum decrease in leakage in the valve, the clip can un-grip and re-grip as many times until the surgeon deems appropriate.
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I have performed several successful minimally invasive procedures using a device such as MitraClip that helps in clipping the leaflets of mitral valve together through a vein in the leg. A catheter-based minimally invasive surgery enables faster recovery, reduction of hospital stays and improves symptoms. Technology is constantly evolving, aiding doctors to treat their patients more effectively. One of the main benefits of this innovative treatment is the improvement in the of quality of life of patients. During old age when a person wants to stay stress-free, medical machines offer a ray of hope. It gives me happiness that I am able to make a difference in the life of even one patient.
Mitral valve repair surgery using this technique has been used in over 100,000 patients from across the world, improving outcomes, and restoring their normal quality of life. From occluders for closing heart defects to pacemakers that can detect sleep apnea, medical intervention in cardiac care has come a long way. With the convergence of many scientific and technological breakthroughs, the pace of medical invention is accelerating, resulting in better patient outcomes. Medical technology in cardiac care that simply treats the mitral valve by clipping its leaflets together through a vein in the leg, is a boon to patients suffering from MR. Thus, if we are to fight the menace of CVDs, we must be willing to adapt and adopt to new technologies and innovations.
Source: ET HealthWorld
