Visit preparation
Can a clip repair severe mitral regurgitation?
A catheter-delivered clip can reduce leakage in some patients. The team first checks whether the valve itself is damaged or the heart has enlarged, then considers surgical risk, response to treatment and whether the leaflets can be securely grasped.
Severe leakage can have different causes
Severe mitral regurgitation is the starting point for assessment. In primary regurgitation, the valve leaflets or their supporting cords may be damaged. In secondary regurgitation, enlargement of a ventricle or atrium can shift the leaflets so they no longer meet properly. Echocardiography helps show how much blood leaks and why.[1]
Transcatheter edge-to-edge repair (TEER) brings part of the front and back leaflets together with a clip to reduce backward flow into the left atrium. It preserves the original valve. Whether it can be used depends on where the leak is and whether the clip can hold both leaflets securely.[1,2]
Which treatment addresses the cause?
For severe primary regurgitation requiring intervention, surgical repair is generally preferred when the patient can tolerate it and a durable repair is expected. The heart team may consider a clip for patients with significant symptoms, high surgical risk and suitable valve anatomy.[1]
If changes in the left ventricle are the main cause, the doctor first evaluates and optimises heart failure treatment. The leak improves in some people as heart function improves. Persistent symptoms and severe leakage despite appropriate treatment warrant further assessment for intervention. The treating doctor decides medicines.[1]
How a team in China planned clip placement
In cases reported by Fujian Provincial Hospital, the team used transoesophageal echocardiography to measure leaflet length at the proposed grasping site, valve opening area and the pressure difference across the valve. After clipping, the team checks for residual leakage and whether forward flow is restricted. A narrow opening can affect the plan even if the leak can be reduced.[2,3]
The hospital reported less leakage after the procedure, with no long-term follow-up or complete adverse-event data. Bleeding and device-related complications are possible. Short-term echo results do not replace follow-up.[2,3]
Bring the original echo clips
Bring the written report, original moving echo images and records of heart failure treatment or hospital stays. Ask which type of regurgitation you have, which leaflet area needs attention and what surgery or clipping could achieve.
If you have had the procedure, take your pre- and post-procedure echo results to follow-up and ask about leakage and the pressure gradient. Use the guide to follow-up after returning home to list the records to transfer.[3]
Need help?
Tell us about your situation and needs. Incomplete records are welcome.