Valvular heart failure is becoming more evident. Having open heart surgery is not always clinically appropriate therefore the development of less invasive methods are crucial to help people receive the treatment they deserve.

The heart is divided into four chambers, and for the blood to flow from one chamber to another, valves function as gates. They open and close so that the blood does not flow backwards and ensures it flows in the right direction. If there are problems with one or more of the valves, this can affect how efficiently the heart pumps, this is termed heart failure. If your doctors have found that you have a problem with a valve in your heart as a result of it being damaged or diseased, there are usually two problems that your doctor may say is wrong with the valve:

Stenosis – the valve is stiff so cannot open and close properly, meaning that the heart has to work harder having to force the blood to pass through the stiff valve.

Regurgitation – this means that the valve leaks. As a result, the heart has to pump harder due to the blood leaking backwards, so it has extra work to do to get the blood to where it should be flowing.

The mitral valve is a one-way valve that sits between the left atrium and left ventricle. There are two reasons why you may have mitral regurgitation, either as a result of degenerative disease thereby the valve does not function well, or it will leak as a result of the left ventricle being enlarged (dilated), thus unable to eject the blood efficiently blood flows back into the right atrium. This can result in symptoms of heart failure, including breathlessness, the gathering of fluid in the legs, extreme tiredness and lethargy.

If the problem with the mitral valve is severe then the traditional way of fixing the valve would be to have open heart surgery and either repair it or replace it. However, for some patients, this is not an option, perhaps due to poor general health, or an already poorly functioning heart.

Over the last decade, a new device has been created called a Mitra Clip that can be fitted without the need for open heart surgery. The device is fitted via a catheter that is inserted via the femoral vein situated in the groin and guided into place by x-ray.

The device clips the mitral valve leaflets together so that a smaller orifice does not allow the blood to flow backwards into the right atrium.

As with any form of surgery, there is always a chance of bleeding or infection. The device has undergone considerable trials in the USA and Europe and continues to be assessed here in the UK.

A careful history and range of investigations are undertaken to assess suitability for Mitra Clip.

Active MitraClip centres include:

1) Brompton Hospital, London
2) University Hospital North Midlands, Stoke-On-Trent
3) Kings College Hospital, London
4) St Bartholomew’s Hospital, London
5) Edinburgh Royal Infirmary, Edinburgh
6) Golden Jubilee hospital, Glasgow
7) Leeds General Infirmary, Leeds

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