Catheter-directed procedure for the treatment of high-grade symptomatic leakage of the mitral or tricuspid valve (mitral or tricuspid regurgitation).
The main symptom is shortness of breath on exertion and later also at rest (dyspnea). In addition, water retention in the legs (edema) may occur.
The following preparatory examinations are necessary: Cardiac ultrasound via the esophagus (transesophageal echocardiography), cardiac catheterization diagnostics with imaging of the coronary vessels and, if necessary, measurement of the pressure values in the pulmonary circulation.
The procedure is performed under general anesthesia and mainly under ultrasound guidance (transesophageal echocardiography). A steerable catheter system is positioned into the atrium of the left heart via the leg vein and across the atrial septum. From here, one or more clips are placed in the leaking area of the heart valve. The valve leaflets are grasped and brought together, thereby reducing or eliminating the leak. Two different catheter systems with different clamp sizes are now available, so that very precise treatment is possible. The catheter system is then removed and the puncture site in the leg vein is sutured. The procedure takes about 60 minutes.
If anatomically suitable, leakage of the tricuspid valve (tricuspid regurgitation) can also be treated with the same catheter systems. In this case, the catheter system is positioned in the area of the atrium of the right heart; the atrial septum does not have to be overcome.
After the intervention, monitoring is necessary for at least six hours, and bed rest with a pressure dressing should be maintained for approximately three hours. In total, an inpatient stay of at least one to two nights must be expected.