MitraClip, the Newest In Severe Mitral Regurgitation Treatment Successfully Performed at Narayana Health City

The patient was leading a normal life until three months back when he started experiencing breathlessness on exertion. In fact, he couldn't keep pace with his colleagues during his morning walk and was suffering from easy fatigability. His symptoms gradually progressed and he started having breathlessness even at rest, which made him and his family seek medical help. He visited a hospital in Assam, as he hails and resides there and was told that his heart functioning was low especially his Left Ventricle Ejection Fraction was below the normal range. Left ventricle ejection fraction is the percentage of blood that is pumped out of the left ventricle (this ventricle is responsible for pumping blood to the brain, heart arteries, and the rest of the body) with each heartbeat.

The ideal LV ejection fraction is 50% to 70% however, in the case of this patient it was 25% indicating a concern. He was also diagnosed to be having severe leakage of the mitral valve (Severe Mitral Regurgitation). Mitral Valve Regurgitation is a condition wherein the valve that prevents the blood from flowing back to the left atrium is leaky. In severe mitral valve regurgitation, the blood doesn't flow forward into the aorta the way it should causing the heart to work harder and eventually leading to heart failure. He was advised of surgery. However, he and his family decided to come to Narayana Health City, Bangalore for a second opinion.

The patient was admitted at Narayana Health City. The team of doctors from Cardiac Sciences evaluated the patient in detail. The coronary angiogram showed no blocks and his ECG made him ineligible for Cardiac Resynchronization Therapy (Device Therapy), leading the doctors to explore newer treatment modalities. They evaluated the possibility of MitraClip. Under the aegis of Dr Satish Govind, Head of Non-Invasive Cardiology, Narayana Health City, the team of doctors conducted a 2D Echo Doppler assessment which confirmed the eligibility of the patient for MitraClip. With the consent of the patient's family, the procedure was performed on World Heart Day ie, 29th September 2021. In this procedure, the mitral valve of the patient was accessed using a thin tube called a catheter that is guided through a vein in the leg and a small clip is implanted in the mitral valve. The implant clips the two leaflets of the mitral valve and reduces the leakage thereby restoring the normal blood flow through the heart. The procedure was successful and was done by the team of Senior Interventional Cardiologists consisting of Dr Uday B Khanolkar, Sr Consultant - Interventional Cardiology, Dr Bagirath Raghuraman, Sr Consultant - Interventional Cardiology and Heart Failure and Dr Sanjay Mehrotra, Sr Consultant - Interventional Cardiology

Elaborating about the case study, Dr Uday B Khanolkar, Sr Consultant - Interventional Cardiology Narayana Health City, said, "The case of this patient is a unique one as owing to his symptoms of extreme breathlessness in spite of maximum medications and not eligibility for CRT, we had to deliberate extensively before finalising the apt one, ie, MitraClip. MitraClip has been proved to offer a significant reduction in mitral regurgitation. Further, it does not call for the surgical opening of the chest and temporarily stopping the heart. It is minimally invasive which means less possibilities of blood loss or scars and shorter hospital stay."

"Further, the case of this patient is very distinct as he is considered to be the first patient to have undergone the procedure in Karnataka," added Dr Uday B Khanolkar, Sr Consultant - Interventional Cardiology Narayana Health City, who has undergone training for this procedure at the prestigious institute in the USA, Cedars-Sinai Medical Center.

Sharing his joy, the patient said, "I have been an active person and the inability to perform even the basic task like my morning walk with symptoms progressively deteriorating to breathlessness even at rest and interfering with sleep, had shattered me completely. I am extremely grateful to the team of doctors at Narayana Health City for not only treating me but also helping me to get back to the normal and active life that I was leading."

The patient was up within 6 hours of the procedure with significant improvement of his symptoms. Post-procedure echo also showed only mild mitral regurgitation.

MitraClip procedure performed at Narayana Health City not only stands as an example of clinical excellence of Narayana Health City, it also provides a ray of hope to those suffering from severe valvular leakage and Heart failure.

With all super-speciality tertiary care facilities that the medical world offers, Narayana Health is a one-stop healthcare destination for all. Founded by Dr Devi Shetty and headquartered in Bengaluru, Narayana Health group is the second largest health care provider in the country in terms of operational bed count. The first facility was established with approximately 225 operational beds in the year 2000 at NH Health City in Bengaluru. The Company today operates a chain of multispecialty tertiary and primary healthcare facilities across a network of 23 hospitals and 7 heart centres in India and a single hospital overseas at the Cayman Islands with nearly 5,900 operational beds across all its centres and the potential to reach a capacity of over 6,800 beds

For details, please visit www.narayanahealth.org.

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