Transcatheter Mitral Valve Repair (TMVr)

The following steps provide a general overview of the TMVr procedure with the MitraClip™ system. Your doctor will explain the procedure to you and can provide you with specific details and answer any questions you may have.

• Your doctor will make a small incision in your upper leg, where a Steerable Guide Catheter (a hollow, flexible tube slightly larger than the diameter of a pencil) will be inserted through a vein to reach your heart.
• The MitraClip™ implant, which is attached to the end of a Clip Delivery System, will be guided, using imaging equipment, to your mitral valve through the catheter for placement.
• Your doctor will implant the Clip at the appropriate position on your mitral valve. The Clip will grasp the mitral valve leaflets to close the centre of the mitral valve and reduce mitral regurgitation.
• Your doctor will then perform tests to confirm that the Clip is working properly. In some cases, your doctor may implant a second Clip for further reduction of mitral regurgitation.
• Once the Clip is in place and working properly, it will be disconnected from the Clip Delivery System.
• The Clip Delivery System and the Steerable Guide Catheter will then be removed from your body and the incision in your leg will be closed.

The implanted Clip will become a permanent part of your heart, allowing your mitral valve to close more tightly and reduce the backward flow of blood.

You should experience relief from your symptoms of mitral regurgitation soon after your procedure.

• You will need to stay in the hospital from one to five days, depending on your recovery and overall health.
• You will undergo close monitoring during this period. Your doctor will perform several tests to understand your heart function.
• You may need to take blood-thinning medications for some time after the procedure. This is to decrease your risk of developing a dangerous blood clot.
• You will be given instructions about your medications by your doctor or nurse before you are discharged from your hospital.
• You will be discharged from the hospital and kept under the care of your family doctor or cardiologist, who will conduct follow-up appointments.
• It is critical that you report for all follow-up appointments and adhere to the instructions of your doctor.
• Most patients will not need special assistance at home following discharge from the hospital, other than for ongoing needs for any unrelated health conditions.

• Limit strenuous physical activity (such as jogging or activities that cause shortness of breath, grunting, or straining when lifting heavy objects) for at least 30 days, or longer, if your doctor thinks it is necessary
• Carefully follow your doctor’s instructions regarding medications you need to take, especially if blood-thinning drugs are prescribed
• Call your doctor if you cannot keep taking your medications because of side effects, such as rash, bleeding, or upset stomach
• Notify your doctor before any medical or dental procedure; you may need to be prescribed antibiotics to avoid potential infection

After your procedure, you will receive an Implant Identification Card, which your doctor will fill out and which you must carry with you at all times. This card identifies you as a patient who has a MitraClip™ implant.

• Show your Implant Identification Card if you report to an emergency room.
• If you require a magnetic resonance imaging (MRI) scan, tell your doctor or MRI technician that you have a MitraClip™ implant. Test results indicate that patients with the MitraClip™ implant can safely undergo MRI scans under certain conditions described on the card.