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St. Clair Cardiologists Offer a New, Minimally Invasive Option for Treating Mitral Valve Regurgitation By Nancy Kennedy
For others, mitral regurgitation produces symptoms that are both uncomfortable and disabling. Symptoms include shortness of breath, fatigue, swelling of the feet and lower extremities, dry cough and excessive urination. Without treatment, mitral regurgitation is likely to become progressively worse and can ultimately lead to heart failure, which causes severe, life-limiting symptoms and eventually death. “As the mitral valve leaks and blood flows back into the lungs, there is an increased load on the heart; the ventricle has to work harder to pump and it gradually dilates,” explains Andy C. Kiser, M.D., chief of cardiac surgery at St. Clair Hospital and an expert on valve disease. “An enlarged ventricle cannot function effectively and this leads to heart failure. We frequently see patients with mitral regurgitation in St. Clair’s Heart Failure Clinic.” Treatment for mitral valve regurgitation, including the most advanced minimally invasive procedure known as transcatheter mitral valve repair, can be found at St. Clair Hospital. Expert cardiac specialists at St. Clair now offer this option to older adults with severely deteriorated mitral valves and heart failure. These patients are too clinically high risk for the traditional open heart surgical repair or replacement of the mitral valve. Instead, a small device called a MitraClip is implanted in the heart by way of a catheter-based delivery system to more completely close the mitral valve, restoring normal blood flow. The MitraClip joins the valve’s leaflets together and holds them in place. “The MitraClip can keep the patient out of heart failure,” says Dr. Kiser. “Once it is in place, the valve is no longer leaking and the blood is flowing in the right direction again. The heart failure becomes much more manageable.”
“The MitraClip is one more way that we can help people with heart disease who are very sick,” says Dr. Cater. “When their hearts can no longer compensate for the leaking valve, and they are too frail for surgery, this is an option that can help some of our patients who are very sick, improving their heart failure and enhancing their quality of life. It’s exciting to see the patient get better. Many patients experience immediate relief of symptoms.” Dr. Cater came to St. Clair for the opportunity to do advanced cardiac imaging. “I’m excited by how the heart program is growing here,” he says. “St. Clair is introducing new, improved technologies such as cardiac MRI, stress cardiac MRI and coronary artery scanning. In the new outpatient building, we’ll have excellent technology for diagnosing and treating heart disease for the community. We’ll be able to help a lot of people. Procedures like the MitraClip implantation are changing lives and it’s exceptional to find this technology and this level of sophistication in a non-academic hospital.”
To learn more about cardiac care at St. Clair Hospital, visit www.stclair.org/services/az-listing/cardiovascular-services/  |
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 Western Pennsylvania Guide to Good Health. All rights reserved. |
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If you have a leaking mitral valve in your heart – a condition known as mitral regurgitation – you are not alone. It’s one of the most common forms of structural heart disease, affecting one in ten Americans over the age of 75. But not every person is affected in the same way; some have a mild degree of leaking with no symptoms at all and are unaware that they even have the condition. 
George Cater, M.D., is a board-certified cardiac imaging specialist and echocardiologist who joined St. Clair’s cardiology program in July 2020. Dr. Cater is an expert in the MitraClip procedure, a complex process that requires an entire multidisciplinary team of cardiology specialists: Jeffrey C. Liu, M.D., board-certified electrophysiologist, gains access to the mitral valve by making a tiny puncture, using a special needle, in a precise location. Ryan Zuzek, M.D., board-certified interventional cardiologist, and Dr. Kiser, at Dr. Cater’s direction, then bring the catheter delivery system into the heart and direct it down over the valve, grasping the leaflets and bringing them together so that the edges are approximated. The procedure lasts several hours and most patients are discharged in two or three days.
