Cardiology - Main Campus
111 Colchester Avenue
Main Campus, McClure, Level 1
Burlington, VT 05401-1473
If you have been diagnosed with mitral valve regurgitation (MVR), a leaky heart valve, and are not a candidate for surgery, we have a new, nonsurgical option that may improve your quality of life.
Transcatheter mitral valve repair (TMVR) reduces leakage by partially closing the valve with a clip. It does not repair the leaky valve completely, but it should improve your symptoms of MVR, including shortness of breath and fatigue.
TMVR: Our Approach
TMVR is a new treatment option to improve the quality of life for patients who cannot undergo standard surgical options. At the University of Vermont Medical Center (UVM Medical Center), we are always looking for innovative treatments to help our patients. Our goal is to provide the most effective care for our community.
- Comprehensive cardiac center: We offer the full range of cardiac and vascular services. We have the most sophisticated diagnostic technologies, surgical equipment and facilities in our region, so we can provide you with the expert care you need. Our surgeons, cardiologists, doctors and medical staff are the region's cardiac experts. Read more about our full-service heart and vascular department.
- Holistic approach: Every patient is unique. Heart conditions can be complicated and can contribute to or cause additional medical issues. We will assess you fully and treat the causes of your heart condition as well as any secondary issues.
- Clinical trials: As an academic medical center, we are at the forefront of innovation. If current treatments are not getting you the results you want, we may be able to enroll you in a clinical trial of a new technique or treatment.
Are you a Candidate for TMVR?
TMVR is not for everyone. To qualify for this procedure, you must have:
- Mitral valve regurgitation (MVR): A cardiologist has diagnosed you with a leaky mitral heart valve caused by a physical defect in the valve. Learn more about mitral valve regurgitation.
- Symptoms: You have shortness of breath, fatigue or other symptoms that adversely affect your quality of life and/or could lead to a heart attack or heart failure.
- Ineligible for surgery: A cardiac surgeon or cardiologist has determined you are not a candidate for surgical mitral valve repair or replacement. Read more about mitral valve surgery.
What is TMVR?
Patients with MVR have a leaky mitral valve, and some blood flows backward each time the heart beats. TMVR is a new treatment option that reduces leaking by using a clip to hold the valve partially closed.
The procedure involves:
- Inserting percutaneous catheter: We insert a catheter, a thin tube, through your skin (percutaneous) into a blood vessel in your groin. The catheter moves through the blood vessel and into your heart.
- Placing MitraClipÂ®: Using the catheter, we place a clip (similar to a tiny clothespin) to pinch parts of the loose valve together. This tightens the valve, but because it leaves gaps on either side of the clip, it doesn't completely stop leakage.
- Ensuring optimal placement: We use echocardiography (ultrasound imaging) to view where we place the clip. We watch how the blood flows with every heart beat to determine if the clip has stopped enough leakage. If it hasn't, we can reposition it or add another clip.
Preparing for Your TMVR Procedure
TMVR is a nonsurgical procedure. However, you will be under general anesthesia, and it is important to be prepared:
- Specific instructions: Your interventional cardiologist and anesthesiologist will explain the pre-operative preparations. These instructions are for your safety and to make sure the procedure is a success.
- Health clearance: Your cardiologist and/or other physicians will examine you to make sure you are healthy enough to undergo the procedure.
- Outpatient procedure: The procedure typically takes between 2 to 3 hours. After your anesthesiologist has determined you are fully awake and have recovered from the effects of anesthesia, we will admit you to the hospital. After 1-2 nights of recovery and medication adjustment, we will discharge you, and you can go home. Remember to follow all the instructions we give you upon discharge.
- Follow up: We will contact you in the days after your procedure to make sure your recovery is going smoothly. We will answer any questions you have and help you however we can.
Related Treatments or Tests
TMVR is only for MVR patients who are not eligible to undergo surgery. For patients who are healthy enough for surgery, we offer both conventional and minimally invasive mitral valve surgery. We operate through small incisions to minimize bleeding and damage to your body. Minimally invasive procedures also reduce the risk of infection and lessen your recovery time. We offer:
- Repair: This is the first and best surgical option because it maintains the integrity of your heart valve and in most cases is a permanent repair.
- Replacement: If your mitral valve is too severely damaged to repair, our surgeons can replace it. Replacement valves can be made from tissues from human donors or animals, or they can be made from strong synthetic materials that do not react with your body. Tissue valves typically last between 10 and 15 years. Mechanical valves should last a lifetime.
For TMVR Medical Professionals
The best treatment options for patients with symptomatic MVR is surgical repair of the valve or valve replacement. Unfortunately, not all patients are good candidates for these minimally invasive surgeries.
TMVR may be an option for a patient whose quality of life is seriously affected by MVR symptoms and who cannot tolerate surgery. Benefits include:
- Increased mobility and endurance: Shortness of breath, fatigue and weakness can limit your patients' daily activities. Most patients see improvements in these symptoms after the procedure.
- Improved general health: With the improvement in MVR symptoms, your patients may see improvements in their general health as they become more active.