No need to open your chest! Is the heart "valve" mitral valve closed badly? Clip clamp!

Text/Yangcheng Evening News all-media reporter Chen Hui

Correspondent Peng Fuxiang Liang Jiayun

Photo/Courtesy of respondents

The mitral valve is one of the important valves in the heart that controls the direction of blood flow, and if this valve is not closed completely, it may lead to blood reflux, causing a decrease in heart function, and even heart failure.

In the past, this problem was mainly solved through surgery, but on January 5, the First Affiliated Hospital of Sun Yat-sen University held a press conference announcing that the hospital had successfully completed the first interventional operation of implanting mitraClip, a mitral valve repair product, transfessal vein into the human body, and the patient is currently recovering well.

This treatment method is to put a 1.2 cm clip into the position where the mitral valve does not close well through the blood vessel, and then use this clip to clamp to improve the closure, because there is no need for open chest and cardiopulmonary bypass, so this treatment method is more suitable for patients with underlying diseases who cannot tolerate major surgery.

During surgery

10% of older adults aged 75 years and older have mitral regurgitation problems

For middle-aged and elderly people, "mitral regurgitation" is not unfamiliar. Mitral regurgitation is the most common heart valve disease, with a prevalence 5 times that of aortic valvular disease, and statistics show that 10% of the elderly aged 75 years and older have mitral regurgitation problems. The mitral valve is one of the important valves in the heart that controls the direction of blood flow, and if this valve is not closed completely, it may lead to disordered blood flow, which in turn can cause a decrease in heart function and even lead to heart failure.

Professor Dong Wugang, director of the Department of Cardiovascular Medicine of Zhongshan First Hospital, introduced that there is no need for intervention for mild mitral regurgitation, and only needs to be regularly observed or treated for the primary disease.

For moderate to severe mitral regurgitation, it is first considered to carry out standardized and adequate drug therapy, and most of the conditions can be alleviated and improved after treatment. For a small number of patients with mitral regurgitation who do not respond to drug therapy, in the past, the main means was to repair or replace the mitral valve through surgery, but this operation required open chest opening and the establishment of cardiopulmonary bypass, but many severe patients could not tolerate such surgery because of high risk factors such as poor cardiac function, advanced age, and comorbidities.

At present, the international minimally invasive mitral valve interventional treatment technology is in the ascendant, and this technology is still in its infancy in China.

A 1.2 cm long "small clip" clamps the incomplete closure of the mitral valve

Associate Professor Li Yi of the Department of Cardiology of Zhongshan First Hospital introduced that on the morning of December 3, 2021, he cooperated with Associate Professor Zhuang Xiaodong of the Department of Cardiology of Zhongshan First Hospital and Associate Professor Yao Fengjuan of the Department of Ultrasound Medicine to successfully complete the implantation of MitraClip, a transfemoral mitral valve repair product, for a 75-year-old woman. The patient began to experience chest tightness, dyspnea and other discomforts three months before surgery, and cardiac ultrasound showed severe mitral regurgitation and cardiac insufficiency.

After the team gave the patient general anesthesia, under ultrasound guidance, the instrument punctured the atrium through the femoral vein, sent the system into the patient's left atrium, reached the regurgitation of the mitral valve, and successfully implanted a 1.2 cm long mitral valve clamp by assessing the location of the mitral valve reflux, the capture position, the degree of reflux, and successfully implanted a 1.2 cm long mitral valve clamp, which just clamped the incomplete part of the closure. After the operation, the patient's reflux situation improved significantly, the pulmonary venous reflux disappeared, and the physiological indicators were normal.

Patients with hypertension and cardiovascular diseases such as coronary heart disease check the heart ultrasound every year

According to reports, this is the first human implant of MitraClip in Zhongshan First Hospital, and this operation is a new progress after the team's first implantation of the transfemoral mitral valve repair product Dragonfly. The team simultaneously completed the first implantation of two types of mitral valve clamp products, Dragonfly and MitraClip, marking another major breakthrough in the field of valve structure in the Department of Cardiology of Zhongshan First Hospital.

Professor Liao Xinxue, general secretary of the party branch of the Cardiovascular Medicine Department of Zhongshan First Hospital and director of the Department of Cardiology, reminded that the heart has a strong compensatory capacity, and after the mitral valve is incomplete, the patient can have no discomfort for more than ten years, or even twenty years, but once the disease progresses to the point of being unable to compensate, the patient will have discomfort such as wheezing upstairs, waking up in the middle of the night, and the condition will take a sharp turn, and generally half a year may develop to severe heart failure.

Therefore, he called on patients with cardiovascular diseases, such as hypertension and coronary heart disease, to do cardiac auscultation, electrocardiogram examination, and cardiac ultrasound examination at least once a year, and if abnormalities are found, they should go to the cardiology specialty in time to receive standardized treatment. If there is discomfort such as palpitation, chest tightness, shortness of breath, etc., it should be paid more attention to. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)

Source | Yangcheng Evening News Yangcheng Pie

Editor-in-charge | Cui Wencan