Nearly 2 million Americans have severe heart failure. There has not been much doctors can do to help these patients except prescribe medications that lessen symptoms. It has been a diagnosis with a poor prognosis — until now. The New York Times reports that research on a new device was released Sunday, and it has cardiologists excited about the number of previously untreatable patients that now may be able to live longer lives.
In a clinical trial that cardiologists say was executed “impeccably,” 614 patients in the United States and Canada, who had been diagnosed with severe heart failure, were randomly assigned into one of two groups. Both groups continued with their standard care, but one of them also received a MitraClip. Of those who continued with standard care, 151 were admitted to a hospital for heart failure within two years. Sixty-one of them died. Of those who continued with standard care and received the MitraClip, 92 were hospitalized within two years, and only 28 died. The findings dispel previous doubts that fixing the mitral valve in patients with severe heart failure would be of much benefit.
A patient with severe heart failure has usually suffered a heart attack that left their heart flaccid, damaged, and unable to pump blood in an efficient manner. The heart tries to overcome the inefficiency, leading to enlargement. This puts stress on the mitral valve, the valve that controls blood flow from the left atrium to the left ventricle. The stress pulls the flaps of the valve apart, allowing blood to flow back into the heart or lungs. This causes more enlargement of the heart, more stress on the valve, and the cycle continues.
#COAPT data at #TCT2018 showed #MitraClip + medicine was superior to medicine alone when treating select #heartfailure patients who have clinically significant secondary #mitralregurgitation.— Abbott (@AbbottNews) September 23, 2018
Press release: https://t.co/Ynx6n7q81N
Important Safety Info: https://t.co/ZZy15CMgns pic.twitter.com/6CIU2TYQ4B
Surgery with the MitraValve involves the surgical placement of the device in the valve. Patients with severe heart failure are typically not healthy enough to undergo open heart surgery, but surgeons place the MitraValve by threading it up through a blood vessel in the groin. When it reaches the valve, it is used to literally clip the flaps together. It’s a procedure that would require precision and training, but one that holds great promise for patients with severe heart failure.
Dr. Mathew Williams, director of the heart valve program at NYU Langone Health, called the breakthrough “a gamechanger,” adding that, “This will change how we treat these patients.” Williams believes that it’s possible that outcomes could be even better if the procedure were performed on patients before they were so frail from severe heart failure.
“Maybe we need to start intervening earlier,” he said.