Mitral valve insufficiency is a leak in the mitral valve. It is the second most common acquired heart valve defect after aortic valve stenosis. The mitral valve regulates the flow of blood from the left atrium of the heart into the left ventricle. When the heart valve opens, oxygen-rich blood enters the left ventricle and when the valve closes, it is pumped further into the systemic circulation to supply the organs from the left ventricle. If there is a leak in the mitral valve (mitral valve insufficiency), the valve does not close completely and some of the blood flows back into the left atrium and the pulmonary circulation. This causes shortness of breath (dyspnoea), water retention and a significant reduction in the patient's ability to cope with everyday stress. In the long term, this is associated with damage to the heart muscle.

Until now, mitral valve surgery has been the standard procedure. However, for a large number of patients with mitral valve insufficiency, surgery is not an option due to severe concomitant diseases, advanced age or a severe restriction of the heart's pumping function and the associated high surgical risk.
Since 2008, catheter-supported mitral valve reconstruction using MitraClip® (Abbott Vascular) has been a minimally invasive procedure that makes it possible to reduce leakage of the mitral valve (mitral valve insufficiency) without surgery. It is not necessary to open the chest for this procedure.
The cardiology department at Ulm University Hospital is one of the most experienced centres in Germany in the treatment of mitral valve insufficiency with the MitraClip® system. To date, more than 500 patients with mitral valve insufficiency have been successfully treated with a MitraClip® by the team of experienced cardiologists led by Prof. Rottbauer, ultrasound specialists and anaesthetists. The procedure is performed several times a week in one of the new state-of-the-art hybrid catheterisation laboratories.

In order to be able to decide whether you are eligible for MitraClip® therapy, a precise diagnosis is first made using ultrasound (swallowing echocardiography) and right-left heart catheterisation in order to determine the best therapy option for each individual patient.

MitraClip® therapy is currently the best established procedure for the catheter-based treatment of mitral valve insufficiency.

The procedure is performed under general anaesthetic. A catheter is advanced into the right atrium of the heart via the vein in the groin and into the left atrium by puncturing the atrial septum. The MitraClip® is located at the tip of the catheter. The clip is positioned precisely between the mitral valve leaflets under X-ray and continuous ultrasound guidance. Ultrasound monitoring enables the clip to be repositioned to achieve an optimal result.

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By attaching the clip to the mitral valve leaflets, a double opening of the valve is achieved, analogous to surgical procedures. Once the MitraClip® is in the correct position, the catheter is removed.

After the procedure, you will be monitored in our intensive care unit for a few hours before returning to the normal ward for further aftercare. Discharge is possible after approximately 5 days, depending on your general condition and concomitant illnesses. After MitraClip® implantation, blood should be thinned for a set period of time.
In order to achieve the best treatment success, the medication should be adjusted and regular ultrasound checks of the heart should be carried out. The cardiology department at Ulm University Hospital offers MitraClip® patients a special follow-up programme to regularly check the function of the heart and mitral valve and adjust the medication accordingly if necessary. As part of the quarterly to six-monthly follow-up appointments, a cardiac ultrasound, an ECG and a blood sample will be taken, as well as a detailed discussion with one of our heart valve specialists.
If you suffer from mitral valve insufficiency and have questions as to whether MitraClip® therapy is an option for you, you can make an appointment at any time in our cardiological outpatient clinic in the heart valve consultation hour.