What Is Transcatheter Mitral Valve Replacement (TMVR)?

After about 10 to 20 years, patient who have had a prior surgical mitral valve replacement might develop significant bioprosthetic valve degeneration. As a result, their valve might be regurgitating or the leaflets may have thickened and restricted blood flow through the valve. Traditionally, open surgery was the only option to address this issue; however, with advancement in transcatheter based valve therapies other treatment options are available. In patients who are not a good candidate for repeat surgery consideration, transcatheter mitral valve replacement (TMVR) could be an option. This uses a minimally invasive approach to avoid the need for open heart surgery to replace the degenerated mitral valve.

What Can a Transcatheter Mitral Valve Replacement Accomplish?

After a TMVR, proper blood flow and circulation is restored to your body, giving you more energy. It can also:

• Reduce or eliminate heart murmurs or palpitations
• Reduce or eliminate swelling in feet and legs
• Reduce or eliminate chest discomfort or pain
• Enable you to be more physically active without experiencing fatigue or shortness of breath

What Can I Expect During the Procedure?

This procedure is performed in our hybrid OR under fluoroscopic guidance with an Interventional Cardiologist and Cardiac Surgeon in a similar manner as transcatheter aortic valve replacement (TAVR). A small incision is made in the groin to place a large IV or sheath into the leg vein. Through this sheath, a valve wrapped on a balloon tipped catheter is advanced from the leg vein into the left atrium and then advanced across the mitral valve. Once across the aortic valve, the balloon is inflated to deploy the new valve inside of the old valve. This procedure is often done under general anesthesia.

Recovery

Your recovery will depend heavily on your condition before the procedure. Recovery often involves an overnight observation on our telemetry floor, but further observation may be needed to monitor any heart rhythm issues or other unforeseen issues.  Patients are able to get back to their prior activity with minimal restrictions after leaving the hospital. 

Estimated Recovery Timeline

Many people feel relief of symptoms almost immediately. You will tire easily in the days following hospital discharge, but your energy will increase as you heal. Make sure to keep your follow-up appointments and follow instructions for heart-healthy eating and exercise.

Transcatheter Mitral Valve Replacement Possible Risks

Any medical procedure carries risks, but heart valve repair is typically a safe and effective procedure. You will be given instructions about how to avoid these specific risks, as well as what to do if you experience these issues after your procedure:

• Blood clot or damage to the blood vessel at catheter insertion sites
• Significant blood loss that may require blood transfusion 
• Infection 
• Abnormal heart rhythms
• Stroke
• New or worsening valve regurgitation 
• Rupture of the valve
• Pneumonia