Transcatheter Procedures for Mitral Valve Disease

For some people with mitral valve regurgitation or mitral valve stenosis, specialists at NYU Langone’s Transcatheter Heart Valve Program may recommend a nonsurgical procedure in which doctors use a catheter—a thin, hollow tube—to deliver a device that can improve the valve’s function.

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Other treatment options include robotically assisted mitral valve repair, minimally invasive mitral valve repair, and sternotomy, also known as open heart surgery. Your doctor helps determine the best procedure for you.

Transcatheter Mitral Valve Repair with MitraClip

If you have mitral valve regurgitation, your doctor may recommend transcatheter mitral valve repair using a small device known as the MitraClip®. This device is used to treat both degenerative and functional types of mitral valve regurgitation.

Our MitraClip® program is the busiest in the Northeast region. Among the most experienced in the country, our doctors are able to perform this procedure in about half the time of most programs. This leads to better outcomes for our patients by reducing the risk of complications and allowing them to leave the hospital more quickly—usually the next day, compared to a two-day hospital stay at most programs.

Surgeon Performs a Transcatheter Procedure

In this procedure, which is performed with general anesthesia, a doctor inserts a catheter into the femoral vein in the leg and guides it to the left atrium of the heart. After the catheter is inside the atrium, the doctor moves the MitraClip® through the catheter and positions it above the leak in the mitral valve.

The clip grasps both of the mitral valve’s leaflets, enabling them to close better by reducing any gaps or floppy portions. This helps reduce the backward flow of blood through the valve while allowing blood to flow from the upper and lower chambers of the heart.

When the procedure is finished, the catheter is removed. This procedure does not require incisions or the use of the heart–lung machine. Afterwards, most people experience significant reduction in regurgitation, which reduces stress on the heart and helps people live longer lives with relief from symptoms such as shortness of breath.  

Our doctors are lead investigators for new nonsurgical devices for mitral valve repair, which can be an option for people who are not candidates for MitraClip®. Your doctor helps you decide which treatment is best for you.

Mitral Balloon Valvuloplasty

Mitral balloon valvuloplasty is used for some people with mitral valve stenosis due to rheumatic heart disease. During this procedure, which requires local anesthesia and, sometimes, sedation, surgeons open the stiffened mitral valve with a special balloon.

Using fluoroscopy, a series of real-time X-rays that allow the doctor to view the procedure on a computer screen, the doctor inserts a catheter into a vein in the groin and up to the heart. The catheter contains a balloon that’s expanded inside the mitral valve to separate its stiffened leaflets. The catheter and balloon are removed from the body through the vein.

The majority of patients go home the day of the procedure, and recovery is typically very quick. This procedure has very low rates of complications and many times leads to a good long-term result.

Transcatheter Mitral Valve Replacement

Before transcatheter mitral valve replacement, open heart surgery was the only option for people who need mitral valve replacement. A minimally invasive transcatheter approach makes this procedure an option for some people who are not ideal candidates for open heart surgery.

NYU Langone doctors were the first in world to implant a transeptal transcatheter mitral valve. The procedure was done through the femoral vein through a small incision in the groin. With the help of advanced imaging, the doctor guides a new valve into the heart and anchors it in place. Once positioned, the new valve takes over the work of the diseased valve.

Transcatheter mitral valve replacement is an option for people who are experiencing mitral stenosis or mitral regurgitation in a previously replaced valve. Your doctor can replace the bioprosthetic mitral valve, pushing it to the side and placing a new valve within the metal frame. If the mitral regurgitation or leak is around the prosthesis, instead of a replacement, the team can potentially seal or plug the defect through a catheter-based procedure. The majority of patients return home the day after the procedure.

Patients who have not had previous replacement or repair for their mitral valve may also be candidates for new investigational nonsurgical transcatheter mitral valve replacement.

Our Research and Education in Mitral Valve Disease

In addition to patient care, our doctors are also involved in scientific research and in providing education for medical professionals.