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New heart valve surgery performed in Las Vegas

A new type of heart surgery that uses a tiny clip to mend leaking valves has arrived in Nevada.

Pahrump resident Gary Wilson, 79, on Wednesday became the first patient in the state to have the device, known as a MitraClip, inserted in his heart.

The procedure, performed at Sunrise Hospital and Medical Center in Las Vegas, offers a new option for patients who suffer from leaky heart valves but aren’t eligible for open-heart surgery to repair the problem for various reasons. It’s specifically used to treat a condition known as severe degenerative mitral regurgitation, which occurs when blood leaks backward into the heart due to problems with the mitral valve.

Wilson, a retiree who struggled with shortness of breath and had difficulty walking for extended periods, said he hoped the surgery would allow him to help his wife around the house and do the outdoor activities he loves but hasn’t been able to participate in since last spring.

Within hours of the procedure, he was up and walking, he said Thursday.

“I could walk three times as far as I used to walk and (I’m) not getting short of breath,” he said.

Approved by the the U.S. Food and Drug Administration in October 2013, the MitraClip can relieve symptoms from the condition — including shortness of breath, fatigue, light-headedness and a rapid, fluttering heartbeat — by restoring a more normal blood flow.

Typically, the two flaps of the mitral valve open to allow blood to flow from the heart’s upper-left chamber to the chamber below it. But when the valve doesn’t close properly, blood can flow back into the upper chamber, a process known as regurgitation.

PROBLEM AFFECTS MILLIONS

Insertion of the MitraClip, developed by the Abbott medical products company, seals the flaps of the valve to reduce leaking while allowing blood to flow through normally.

According to a 2009 study, mitral regurgitation affects over 2 million people in the United States. It’s not known how many Southern Nevadans suffer from the condition or would be eligible for the surgery.

Minor or mild regurgitation can cause few to no symptoms and be treated with medication, but severe regurgitation can lead to a buildup of fluid in the lungs or even heart failure.

Though the severe form is often treated with an open-heart surgery, some patients with prior conditions and surgeries don’t qualify for that procedure. The MitraClip surgery is approved for those patients.

The surgery begins with a catheter inserted through a vein in the lower body, rather than with an open-chest approach. The catheter is then guided into the heart and the clip inserted to close the flaps, almost like a staple.

Interventional cardiologist Dr. Nayab Zafar of the Heart Center of Nevada, who led the surgery alongside cardiovascular-thoracic surgeon Bashir Chowdhry, described the procedure as a step forward for Nevada patients with serious mitral regurgitation.

“We were sending our patients all the way over to California, Arizona, Utah, and some people couldn’t travel,” Zafar said.

“They didn’t have resources, so we decided to bring this procedure to the state.”

The surgery isn’t intended to extend life spans so much as improve patients’ lives, Zafar added.

“Most of the things we do are aimed at improving quality of life,” he said. “That’s the goal.”

Some patients with a propensity for blood clots or weakened hearts are not eligible for the surgery, which generally takes 2½ to three hours.

The cost of the surgery was not disclosed, though it is generally covered by insurance, according to a Sunrise hospital spokeswoman.

VOLUNTARY SAFETY NOTICE

Use of the MitraClip is not without risk. A voluntary safety notice was issued several months ago by the manufacturer following a series of errors during implantation surgeries.

The errors were caused by confusion over how to properly detach the clip from the delivery system inside the heart and required open-heart surgeries to retrieve the delivery system, according to the notice.

Nine malfunctioning devices and one death were reported.

As a result, Abbott implemented additional training for physicians and revised its deployment sequence instructions.

Overall, more than 35,000 of the procedures have been performed globally, according to an Abbott spokeswoman.

Zafar, who said Wilson was expected to be released from the hospital Friday, witnessed multiple MitraClip surgeries before performing one on his own so he could learn about proper deployment of the device.

He said Chowdhry was in the room during the procedure to ensure any complications could be dealt with quickly and to lessen the risk of a malfunctioning device or other serious complication.

Wilson said he was aware of the risks associated with the procedure, which also include infection, excessive bleeding and possible puncturing of the heart, but believes the risk was worth it.

“I’m very, very lucky,” he said. “I’m anxious to go home and do things. There’s so many little things I’ve been putting off.”

Contact Pashtana Usufzy at pusufzy@reviewjournal.com or 702-380-4563. Follow @pashtana_u on Twitter.

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