Catheter-based Mitral Valve Repair with the MITRACLIP
Transcatheter Aortic Valve Implantation (TAVI)
Catheter-based Renal Artery Denervation for Resistant Hypertension
The Watchman Device: A Novel Therapy for Prevention of Stroke in Atrial Fibrillation
Absorb Bioresorbable Vascular Scaffold
Dedicated Bifurcation drug-eluting Stent: Axxess Stent
Endovascular repair of aortic conditions: EVAR and TEVAR
Organ Transplantation and Mechanical Heart
Minimally Invasive Mitral Valve Repair and Replacement
Minimally Invasive Repair of Chest Wall Deformities
Cardiac Magnetic Resonance Imaging CMR
Real Time Live 3D TEE-guided Procedures and Surgeries
Sutureless Aortic Valve Replacement
PARACHUTE Left Ventricular Partitioning Device
Cardiopulmonary Resuscitation CPR and Paediatric Advanced Life Support PALS
GrownUp Congenital Heart Disease GUCH
Paediatric & Congenital Heart Centre PCHC
Mitral regurgitation (MR) is a condition whereby the mitral valve leaks. As a result, a significant volume of blood is pushed backward into the left atrium. Left unattended, mitral regurgitation can lead to progressive enlargement of the heart and will lead to heart failure. Common causes for these leakages are usually either functional or degenerative. Conventional treatment of severe MR will be surgery, in the form of either mitral valve repair or replacement. However, this will require an open heart surgery. On occasions, the risk of surgery is high especially when there is coexisting medical conditions or advanced age.
The Mitraclip procedure is a new way of treating MR without the need for open heart surgery. Through the femoral vein in the groin, a catheter is inserted, and then advanced across the atrial septum towards the mitral valve. Mitraclip system is then advanced through the leaflets of the mitral valve. After ascertaining its position and alignment, the clip will be deployed, grasping both leaflets of the mitral valve. This will oppose and stabilize the mitral valve leaflets and treats the leakage. The procedure is done under general anaesthesia and as the placement of the clip needs to be exact and precise, will typically takes 3 to 4 hours to complete.
Institut Jantung Negara (IJN) has successfully performed its first case on mitraclip implantation in a 60 year old man with severe MR due to coronary artery disease on the 16th December 2011. At the time of printing, we have implanted mitraclip for 7 patients. Majority of patients has received single clip and two patients received 2 clips each. We are pleased with the results of the mitraclip. Worldwide, there have been more than 4000 implantations with success rate of 96-98%.
Currently, the procedure is suitable for selected patients with ideal anatomy and central position of the leakage. It is especially so in patients who have high surgical risk for conventional mitral valve surgery. As we gather more experience and with constant improvement in technology, we expect the procedure to be more applicable to a larger group of patients at a lower cost.
Up to December 2013, we have performed 28 MitraClip procedures.