Yashoda Hospital Rd, Somajiguda
Dr Pankaj Heart Care Clinic 1-2-45/1, Domalguda
When a patient has already undergone major heart surgery, treating a new valve problem can become especially challenging. The situation becomes even more complex when severe mitral regurgitation is accompanied by heart failure and the risk of another surgery is considered too high.
This case of a 75-year-old gentleman with previous CABG shows how careful Heart Team evaluation and a minimally invasive structural heart procedure can provide an appropriate treatment option for a selected high-risk patient.
The patient had three important factors that shaped the treatment decision:
With previous cardiac surgery and a high overall surgical risk, repeating open-heart surgery required careful consideration.
The patient's case was reviewed by a multidisciplinary Heart Team. A detailed assessment was carried out to understand his previous cardiac history, current valve condition and available treatment options.
The evaluation confirmed that all of his previous bypass grafts were patented. However, the surgical risk was considered prohibitive.
For selected patients with severe symptomatic primary mitral regurgitation who have high or prohibitive surgical risk and suitable valve anatomy, transcatheter edge-to-edge repair can be an appropriate treatment option.
Based on the patient's clinical condition and assessment, the team decided to proceed with Mitral Transcatheter Edge-to-Edge Repair (M-TEER).
M-TEER is a minimally invasive procedure used to treat certain cases of significant mitral regurgitation. Instead of opening the chest for conventional surgery, the repair is performed using a catheter-based approach.
In this case, the team used the MyClip device, an indigenous transcatheter edge-to-edge repair system, to address the mitral regurgitation.
The decision was based on the patient's individual clinical situation, rather than simply choosing a procedure because it was less invasive.
Complex valve cases often require several factors to be considered together. Previous heart surgery, the severity and cause of mitral regurgitation, heart failure symptoms, surgical risk and valve anatomy can all influence the treatment plan.
A multidisciplinary Heart Team brings these considerations together before a procedure is selected. This helps ensure that the treatment decision is based on the patient's overall condition and available options.
The M-TEER procedure was successfully performed using the MyClip device. Following the procedure, the patient showed marked symptomatic and haemodynamic improvement. He remained stable and was discharged safely after the intervention.
For this patient, the procedure provided a catheter-based treatment option in a situation where conventional surgery carried prohibitive risk.
This case demonstrates several important aspects of modern structural heart care:
The goal of advanced cardiac care is not simply to use newer technology. It is to understand the patient's condition and select an approach that is appropriate for their individual needs.
M-TEER or Mitral Transcatheter Edge-to-Edge Repair, is a catheter-based procedure used in selected patients with significant mitral regurgitation. It brings portions of the mitral valve leaflets together to reduce the backward flow of blood through the valve.
M-TEER may be considered in selected patients with severe mitral regurgitation who have high or prohibitive surgical risk and suitable valve anatomy. A Heart Team evaluates the patient's previous surgery, overall health, valve anatomy and other clinical factors before recommending the procedure.
The M-TEER procedure using the MyClip device was successfully completed. The patient showed marked symptomatic and haemodynamic improvement and was discharged in a stable condition.