Recently, the cardiology team of Rizhao Hospital/Rizhao Heart Disease Hospital affiliated with Qingdao University completed the first case of MitraClip in Rizhao City. It is reported that this technology is a leading technology in China, providing a new treatment plan for elderly, high-risk, and intolerant patients with severe mitral regurgitation undergoing open chest surgery.

The successful implementation of this surgery marks another new breakthrough in our hospital's minimally invasive interventional treatment technology for structural heart disease, which will bring good news and hope to more patients with valve disease.

Grandma Zhang, who is 75 years old, began experiencing symptoms such as recurrent palpitations, chest tightness, and suffocation 10 years ago. She has been hospitalized multiple times in a local hospital for treatment, but her symptoms have not been relieved, and her quality of life is extremely poor. Accompanied by her children, she came to Qingdao University Affiliated Rizhao Hospital/Rizhao Heart Disease Hospital for treatment. After admission, a comprehensive cardiac ultrasound examination showed that Grandma Zhang had "ruptured mitral valve chordae tendineae and valve leaflet prolapse", leading to severe mitral regurgitation. After receiving standard drug treatment, the patient still experienced recurrent heart failure attacks and showed an acute exacerbation trend.

The mitral valve is one of the important structures of the human heart, consisting of two valves that form a one-way valve. The two valves are called the anterior and posterior lobes, which open during diastole and allow blood from the left atrium to flow into the left ventricle. During systole, the mitral valve is closed to prevent blood from flowing back into the left atrium when pumped into the aorta from the left ventricle. If the mitral valve is not fully closed, causing a large amount of blood flow to reflux back to the left atrium during left ventricular contraction and unable to pump into the aorta, unable to supply blood to the whole body, pulmonary hypertension, acute heart failure, and even sudden death may occur in a short period of time.

The urgent task of treating the disease is to solve the problem of mitral regurgitation. However, Grandma Zhang is 75 years old and is complicated with diabetes, primary thrombocytopenia and other complications. If open chest surgery under traditional cardiopulmonary bypass is performed, the risk of complications during the perioperative period is high, and the elderly may not tolerate it.

The cardiology team carefully discussed and analyzed the patient's condition, and immediately organized a multidisciplinary team including cardiology, ultrasound, anesthesia, extracorporeal circulation, and intensive care center to repeatedly discuss Grandma Zhang's condition. After fully evaluating the patient's condition and discussing with the family, it was decided to adopt the most advanced minimally invasive surgical method in the world - transcatheter mitral valve clamp surgery.

"The most effective method for treating mitral regurgitation in the past was to repair or replace the damaged mitral valve through open chest surgery, but the surgical trauma is large and the recovery time is long. For many elderly patients, those with poor heart function or multiple comorbidities have an unbearable risk."

"The biggest difference between the mitral valve clamp surgery in this surgery and traditional surgery is that it is minimally invasive. It only requires a small incision of 3-5 millimeters on the patient's body, which enters through the femoral vein, punctures the atrial septum, and enters the left heart. Under the guidance of esophageal ultrasound and X-ray, a clamp is used to clamp the severe areas of anterior and posterior mitral valve regurgitation, thereby reducing mitral valve regurgitation. Mitral valve clamp surgery has the advantages of small trauma, short surgical time, high safety, and short postoperative recovery cycle." explained Dr. Gao Tingwen, a cardiologist.

After fully evaluating the difficulties and risks that may be encountered during the surgery through interdisciplinary discussions, the cardiology team developed a complete and meticulous surgical plan for Grandma Zhang.

On the day of the surgery, under the guidance of Professor Pan Wenzhi from Zhongshan Hospital affiliated with Fudan University, the cardiology team led by Director Xie Xinxing, Director Li Zhaofeng, and Medical Doctor Gao Tingwen, closely cooperated with surgical teams such as Ultrasound Medicine and Anesthesiology to perform transcatheter mitral valve clamp surgery on Grandma Zhang's beating heart.

The patient underwent femoral vein catheterization and transesophageal ultrasound (TEE) guided atrial septal puncture, followed by insertion of a guiding sheath tube. The clamp was accurately delivered to the mitral regurgitation area. Under TEE and DSA guidance, the surgical team used a Mitraclip to accurately capture the mitral valve leaflet. After trial clamping, ultrasound confirmed its effectiveness, and the formed clamp was released. After postoperative ultrasound evaluation, it was determined that there was still moderate regurgitation in the clamping area. It was decided to implant another clamp in parallel to reduce the regurgitation to a small amount. The clamp was stable and the average cross valve pressure difference was 4mmHg. The patient's physiological indicators were normal, and the mitral valve was finally completed with high quality for the patient. Clamp technique.

The postoperative examination results showed that Grandma Zhang's mitral regurgitation decreased significantly from preoperative to postoperative levels, and her heart function improved significantly. At the same time, minimally invasive surgical methods have also accelerated the postoperative recovery of patients. Grandma Zhang can release the brake within 6 hours after surgery, and the left ventricular ejection fraction has significantly increased after follow-up ultrasound examination. The size of the left atrium and left ventricle has also significantly decreased compared to before surgery. Under the careful care of medical staff, he has recently recovered and been discharged from the hospital.

With the development of medical technology, minimally invasive interventional treatment of valvular heart disease has become an important milestone in the field of cardiovascular intervention. This time, the Cardiovascular Department has once again conquered another technological peak - transcatheter mitral valve clamp surgery, marking a new level of medical technology in our hospital's cardiovascular specialty. It will provide multiple options for the treatment of elderly heart valve patients, which is beneficial to more patients.

In recent years, our cardiovascular department team has closely followed the forefront development of the world's cardiovascular field, repeatedly completed high difficulty surgeries, worked together to overcome difficulties, continuously explored and innovated, and made breakthroughs in the field of structural heart disease while striving for excellence in coronary intervention and electrophysiological pacing technology. The implementation of transcatheter mitral valve clamp surgery marks the leading position of our cardiovascular department in the field of structural heart disease.

In the future, the cardiology team will continue to deepen their expertise in the cardiovascular field, especially in the field of structural heart disease and heart disease. They will continuously improve their diagnostic and treatment techniques, help more patients with cardiovascular diseases overcome their pain, regain their "heart", and contribute to the health of people in Rizhao and surrounding areas.