Heart valve clip improves quality of life for man with leaky heart valves
About five years ago, Russell Rippentrop, then in his mid-70s, noticed he was starting to slow down. He’d had both hips successfully replaced, but he seemed to be lacking his usual energy. He had a heart murmur for more than 30 years. At first it was nearly undetectable, so it didn’t affect his life much. Until it became more severe.
“I found myself sitting around feeling lethargic,” he said. “My primary care provider noticed the heart murmur was getting louder during an annual physical.”
Heart murmurs are unexpected sounds the heart makes when it pumps. Healthcare providers might hear a whooshing or swishing sound through their stethoscopes. Some heart murmurs aren’t worrisome. But some indicate a problem with the heart or its valves. Rippentrop’s primary care provider sent him to a cardiologist for further testing.
Rippentrop had an echocardiogram confirming that a leaky mitral valve was causing his heart murmur. The mitral valve is one of four heart valves that keeps blood flowing in the right direction through different chambers in the heart. When the valve doesn’t close properly, blood might leak the wrong way. When blood flows the wrong direction, the heart must work harder to compensate. With time, this extra strain can lead to complications and heart failure. Mitral regurgitation, or a leaky mitral valve, is a common heart valve disorder. About 9% of people over age 75 experience mitral valve leakage.
The condition can have a significant impact on quality of life. It can lead to shortness of breath, difficulty lying flat, fatigue, chest pain, low energy, dizziness, and swollen feet ankles or legs. Like Rippentrop, many people with a leaky heart valve reduce their physical activity.
Care options for a leaky heart valve
Rippentrop saw the structural heart care team at M Health Fairview St. John’s Hospital in Maplewood to learn about his care options. The valve team is part of the structural heart team. It is a collaborative group consisting of interventional cardiologists, open heart surgeons, advanced practice providers and nurse clinicians who specialize in valvular heart disease. They discuss each individual patient to recommend treatment options for their individual circumstances.
Rippentrop worked with structural heart care coordinator Alex Voltz, RN, BSN- CCRN. Care coordinators and registered nurses like Voltz help guide patients through the process from the time of referral through cardiac rehab and recovery. Patients know they can always contact their valve coordinator directly even after their procedures.
Rippentrop was given two treatment options: open-heart surgery or a less invasive mitral valve repair procedure that involves putting a clip on the valve to decrease the amount of leaking.
Rippentrop chose the less invasive procedure, called a transcatheter edge to edge repair (TEER). The interventional cardiology team, led by Marat Yanavitski, MD, an interventional cardiologist and structural heart specialist, made a small puncture in a vein in the leg and maneuvered a catheter through the vein to the heart. There, a thin, flexible clip was put in place on the mitral valve. When the valve is clipped together, it decreases the amount of leaking and quickly clears the symptoms. The procedure usually takes two to three hours and is done under general anesthesia.
Heart tissue slowly grows around the clip, so it becomes part of the valve. While not the best option for everyone, if appropriate, many people choose the valve clip procedure because it is less invasive and offers a quicker recovery time. Patients who undergo the clip procedure still have the option of open surgical replacement of their valve in the future if needed, but many patients never require another procedure.
“If I did need another mitral clip, it wouldn't bother me because it was a real piece of cake,” Rippentrop said.
Onto recovery
After the procedure, Rippentrop, like many mitral valve clip patients, spent a few hours in recovery and one night in the hospital. They have restrictions on heavy lifting and driving for about five days.
“Our goal is always to improve their symptoms and improve their lives,” Voltz said. “Then we get them to cardiac rehab. A lot of our patients become deconditioned overtime from their valve disease. We try to get them into rehab, so they can work on their stamina.”
After Rippentrop’s procedure in fall of 2022 at St. John’s Hospital, his heart murmur was nearly undetectable. He said if he could do anything differently, he would probably have gotten the procedure sooner because he could have benefited from it longer. Now, Rippentrop is back to working in his yard and does quite a bit of walking.
“I walk probably two or three days a week," he said. “We live right close to a big wildlife area that's got walking trails, so I can do that whenever I choose.”
Learn more about heart care and treatment at M Health Fairview.
