In another first in cardiology, Apollo Hospitals, Chennai, performed India’s First Fourth Generation (G4) Transcatheter Mitral Valve Repair. Dr. Sai Satish, Senior Interventional Cardiologist, Apollo Hospitals and a pioneer in heart valve replacement and mitral valve procedures, successfully performed these mitral valve repairs on three individuals, each of whom were suffering from end-stage heart failure and had flown in from different cities across India. The fourth generation MitraClip™ Transcatheter Mitral Valve Repair System allows for edge-to-edge mitral valve repair. It allows doctors to choose clip size based on a patient’s mitral valve anatomy and a new leaflet grasping technology that allows doctors to grasp leaflets simultaneously or independently.

Speaking about this new technique, Dr. Sai Satish said “These patients had sustained extensive damage to their hearts, and were in refractory heart failure in spite of being optimally treated with medication and all other currently available heart failure devices. Two out of the three also had aortic valves procedures done previously which had further altered their mitral anatomies. The intractable heart failure coupled with these extreme anatomical challenges would have made it impossible to treat them with any conventional device available today. The ability to independently grasp each valve leaflet allows us to now get surgical-like repair results even in these select complex anatomies! All said and done, to me the greatest joy comes from being able to make a difference to otherwise untreatable patients.”

Apollo Hospitals, Chennai is currently the only hospital in India where this technique has been performed and Dr. Sai Satish has performed the highest number of Transcatheter Mitral Valve repairs in the country.

Giving details about the patients, Dr Sai Satish said, “The first patient was a 69-year-old gentleman with Dialated Cardiomyopathy and heart function less than 20% had undergone cardiac resynchronization therapy(pacemaker) for his heart failure as early as in 2007. He was now referred to us for refractory heart failure and severe mitral regurgitation. He had been turned down for any type of surgical intervention including a heart transplant because of multiple co-morbidities and could not have been treated by any of the earlier devices that are available in the market. He had an excellent procedural outcome with almost no residual mitral leak post procedure and he was discharged with no failure symptoms.

“The second patient was a 73-old-year with several challenges had a cardiac arrest from which she was revived and was now referred to us for severe mitral valve leak and cardiogenic shock. Having previously undergone neurosurgery for a meningioma, operated for CA breast and received radiation therapy, and a subsequent fall and hip fracture, she too could not have been treated by surgery or any of the earlier devices. We performed the procedure with great results and almost no residual mitral leak. We also implanted a pacemaker, and she is now completely symptom free with near normal heart function.

“The third patient was a 76-Year-old lady who came to us with persistent severe heart failure from severe mitral regurgitation with multiple cardiac surgical interventions in the past had a successful procedure thanks to this new technique. She now has normal heart function with no heart failure symptoms and was discharged in 3 days.”

With over 4.6 million patients, heart failure in India is today a leading cause of death this technique has proven to be a boon for patients with heart failure due to mitral valve regurgitation. MitraClip has demonstrated proven safety, survival and positive clinical outcomes with a high implant success rate and reduction in mitral regurgitation. This fourth generation clip now brings in more advantages in saving lives of the patients in need.

The milestone of being the first in the country to use the fourth generation MitraClipTM is testament to Apollo Hospitals’ mission to make the latest and best minimally invasive therapies in cardiovascular disease management available for patients as they become the standard of care for patients with heart valve problems who are not improving on medical treatment.


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