Transcatheter Mitral Valve Replacement (TMVR).

What is TMVR?

Transcatheter Mitral Valve Replacement (TMVR) is a minimally invasive procedure used to replace a damaged or diseased mitral valve in the heart. The mitral valve is one of the four valves in the heart that controls the flow of blood between the chambers of the heart. When the valve is damaged or diseased, it can cause blood to leak back into the lungs, leading to symptoms such as shortness of breath, fatigue, and fluid build-up.
During TMVR, a new valve is inserted into the heart through a catheter that is typically inserted into an artery in the groin or the chest. The catheter is guided to the heart using imaging technology, such as X-ray or echocardiography. Once in place, the new valve is expanded and anchored to the existing valve, effectively replacing it and restoring proper blood flow through the heart.

Why and when TMVR is recommended?

Transcatheter Mitral Valve Replacement (TMVR) is recommended for patients who have a damaged or diseased mitral valve in the heart and who are not good candidates for traditional open-heart surgery. This may be due to various factors, such as advanced age, other medical conditions that increase the risk of surgery, or a history of prior heart surgery.
The most common conditions that may require TMVR include mitral regurgitation (a condition in which the mitral valve does not close properly, causing blood to leak back into the lungs) and mitral stenosis (a condition in which the mitral valve becomes narrowed, reducing blood flow to the rest of the body). These conditions can cause symptoms such as shortness of breath, fatigue, and fluid build-up, which can significantly impact a patient's quality of life.
It is also used for patients who already have a bioprosthetic mitral valve which is degenerated with time and have started developing symptoms again. In such group of patients also the mitral valve can be replaced via non-surgical technique.
TMVR is typically considered when the symptoms of mitral valve disease are severe enough to require treatment, but traditional surgery is too risky. TMVR is a minimally invasive procedure that does not require a large incision or a heart-lung machine, which makes it a suitable option for patients who are at high risk for complications from traditional surgery. However, it is important to note that not all patients are good candidates for TMVR, and the decision to undergo the procedure should be made on a case-by-case basis by your doctors.

How is TMVR different from the conventional treatment?

TMVR is different from the conventional treatment of mitral valve disease in that it is a minimally invasive procedure that does not require a large incision or the use of a heart-lung machine. Traditional open-heart surgery for mitral valve disease involves making a large incision in the chest, stopping the heart, and using a heart-lung machine to take over the function of the heart and lungs during the surgery.
In contrast, TMVR involves inserting a catheter into an artery in the groin or chest and guiding it to the heart using imaging technology such as X-ray or echocardiography. The new valve is then delivered to the heart through the catheter and expanded to replace the damaged or diseased valve. The entire procedure is typically completed in a few hours, and patients usually recover more quickly and experience less pain and scarring than with traditional open-heart surgery.
TMVR is generally considered a less invasive option for patients who are not good candidates for traditional surgery due to factors such as advanced age, other medical conditions, or a history of prior heart surgery.

Is TMVR the same as MitraClip?

Your cardiologists use several minimally invasive methods to treat mitral valve disease. Some involves replacement of mitral valve and others repair it. MitraClip is a technique that repair the defective valve.  TMVR, on the other hand, replaces a defective valve.

How is life after TMVR?

Life after TMVR can vary depending on the individual's health status and the severity of their underlying condition. However, in general, people who undergo TMVR can expect to experience an improvement in their symptoms and an overall improvement in their quality of life.

In the days and weeks following the procedure, one will need to be closely monitored by their healthcare providers to ensure that the new valve is functioning properly and that there are no complications. Patients may need to take medications to prevent blood clots or to manage other health conditions.

After the initial recovery period, patients may be able to resume their normal activities, although they should consult with their healthcare provider before starting any new exercise or physical activity program. It is also important for patients to attend regular follow-up appointments with their healthcare provider to monitor their ongoing health and to ensure that the new valve continues to function properly.

It is worth noting that, like any medical procedure, TMVR does carry some risks, including the risk of complications such as bleeding, infection, or damage to the blood vessels or surrounding tissues. However, these risks are generally lower than those associated with traditional open-heart surgery.