UVA is one of the first in the country to offer the MitraClip® procedure: a new, less invasive treatment alternative to open heart surgery. Cardiologist Scott Lim, MD, discusses a recent successful clinical trial called COAPT. This trial followed patients with heart failure undergoing the MitraClip® treatment and discovered a rapidly increased rate of recovery.
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For patients who have heart failure, where their heart muscle has gotten weak, one of the complicating factors that can happen is one of their heart valves, the mitral valve, can also start leaking as well. Simply because the heart muscle just isn’t strong enough to close it. For those patients, it’s really a difficult thing as they struggle with shortness of breath, low energy, sometimes a lot of swelling of their extremities as well.
Previously, the mainstay of therapy has been different medications. But in many patients, despite those medications, they remain quite symptomatic. In the past, we’ve looked at options, including open chest surgery to repair their leaking heart valve, but ultimately, have not found a great option for them.
One of the novel technologies is how to repair a leaking mitral valve through a catheter with a technique called a MitraClip®; the advantages being there’s no incision on a patient’s chest, so the patient gets back to living that much quicker.
What we did not know up until recently is how effective that was. Myself and a number of my colleagues around the country had embarked in a very ambitious clinical research trial called the COAPT trial, where we looked at just those patients who were struggling with heart failure and leaking of their mitral valve. And we investigated how well did this new device, this MitraClip®, work?
What the COAPT trial really showed us, for the first time, is that for those patients undergoing a MitraClip® procedure instead, that that would decrease the likelihood that the patient would undergo a heart pump or heart transplantation for the duration of that study. This is a paradigm shift that we now have.
The recovery period for a MitraClip® procedure is a lot quicker. Most patients come into the hospital, get the procedure done, and that afternoon they’re able to talk to their family. And we watch them one or two nights in the hospital usually at most, with many patients going home the next day.
So the recovery period is shorter, and we’ve always known that. What we didn’t know until recently is how well we were helping patients get out of heart failure. How well we were helping patients stay at home and not come back to the hospital. Now we know that with the MitraClip® therapy, for patients with heart failure and mitral regurgitation, we are making a significant impact and improving the quality of these patient’s lives. Now we also know we’re extending their lives, too.
At the University of Virginia, we’re one of the few sites that offer the availability of a MitraClip® in some format of a continued access trial, or similar devices on ongoing investigation because we believe, based on the data we saw from the COAPT trial, that this could truly help our patients.