Transcatheter Mitral Valve Repair (TMVR)

The mitral valve is one of four valves that regulate blood flow through the heart. The purpose of the heart valves is to ensure blood only moves forward. In mitral valve regurgitation, however, some blood leaks back through the valve; allowing blood to move in both directions. Because of this the heart has to work harder than it should to get the blood out of the body. If the regurgitation gets worse, some blood may start to back up into the lungs. A very small amount of mitral regurgitation is very common. However, a few people have severe mitral valve regurgitation.

Transcatheter Mitral Valve Repair (TMVR) is a minimally-invasive procedure, performed to reduce or eliminate the leaking occurring from the mitral valve.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.

How to Prepare for the Procedure

Prior to a TMVR procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure and potential risks of the procedure. Talk to your doctor about:

• All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
• Diabetes and how to adjust your medicine on the day of the procedure.
• Radiation exposure, especially for those that are pregnant.
• Any allergies to medicines, latex, tape, iodine and anesthetic agents.
• Any history of bleeding disorders.
• Any implanted device (e.g. pacemaker or ICD).
• Any body piercings on your chest or abdomen.

Other recommendations include:

• Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
• Leave all jewelry at home.
• Remove all makeup and nail polish.
• Wear comfortable clothing when you come to the hospital.
• If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to Expect Before the Procedure

Before the procedure, your doctor may perform a variety of tests, including:

• Blood tests
• Cardiac catheterization
• X-Rays
• Echocardiogram (ECHO)
• Electrocardiogram (EKG/ECG)
• Stress test
• Computed tomography (CT scan)
• Angiogram

What to Expect During the Procedure

The TMVR procedure is most commonly performed with the use of the MitraClip device. On average, the time required to perform the TMVR procedure is between 3 to 4 hours. This procedure is usually performed in the cardiothoracic operating room (OR). Check with your doctor about the details of the procedure. In general:

• You will change into a hospital gown.
• A nurse will start the intravenous (IV) line in your arm which will administer medications and fluids during the procedure.
• Prior to starting the procedure, you will receive a local anesthetic.
• Once the anesthetic has taken effect, a small incision in the femoral vein (located in the groin) is made.
• Through this incision, a catheter (small tube) will be inserted and guided directly inside the diseased mitral valve.
• Within this catheter, the MitraClip device is attached. This small device is a small clip that is attached to your mitral valve.
• Once the mitral valve is identified, the clip is released. The clip closes the center of the mitral valve. This will reduce the regurgitation (leaking).
• Once the clip is in place, the catheter will be removed from your body and the incision in your leg will be closed with a closure device or sutures.

What to Expect After the Procedure

After the procedure, you will be taken to the cardiothoracic intensive care unit (CTICU) for further observation. Most commonly, patients will stay in the hospital overnight and return home the day following the procedure. Other recommendations include:

General Guidelines

• A nurse will monitor your vital signs, the insertion site, and circulation and sensation in the affected leg or arm.
• You must stay in bed as long as recommended by your doctor.
• Tell your nurse right away if you feel any chest pain or tightness, or any other pain, as well as any feelings of warmth, bleeding, or pain at the insertion site.
• Your doctor will give you instructions to follow during your recovery.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.