What is transcatheter mitral valve repair?

Transcatheter mitral valve repair (TMVR) is a procedure that helps the mitral valve in your heart close better as your heart beats. Using a catheter, the doctor placed one or more small clips on the valve flaps.

After the procedure, you will spend up to a few days in the hospital. Your groin may have a bruise and feel sore for a few days. This is where the catheter was inserted into your blood vessel.

Most people can return to regular activities in about a month. Your doctor may give you specific instructions on when you can do your normal activities again.

Your doctor may suggest that you attend a cardiac rehab program. In cardiac rehab, a team of health professionals provides education and support to help you recover and prevent problems with your heart. Ask your doctor if rehab is right for you.

Activity

• Allow your body to heal. Do not do strenuous exercise or lift, pull, or push anything heavy until your doctor says it's okay. This may be for at least a month.
• Rest when you feel tired.
• Ask your doctor when you can drive again.

Diet

• Eat heart-healthy foods. These foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit sodium, alcohol, and sugar.
• If your bowel movements are not regular right after the procedure, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Your doctor may prescribe a blood-thinning medicine. Be sure to get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.

Care of the catheter site

• For 1 or 2 days, keep a bandage over the spot where the catheter was inserted. The bandage probably will fall off in this time.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. Put a thin cloth between the ice and your skin.
• You may shower 24 to 48 hours after the procedure, if your doctor okays it. Pat the incision dry.
• Do not soak the catheter site until it is healed. Don't take a bath for 1 week, or until your doctor tells you it is okay.
• Watch for bleeding from the site. A small amount of blood (up to the size of a quarter) on the bandage can be normal.
• If you are bleeding, lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your doctor or seek immediate medical care.

Other instructions

• Carry your device identification card with you at all times.
• Practice good dental hygiene and have regular checkups. Good dental health is especially important. That's because bacteria can spread from teeth and gums to the heart valves.
• Be sure to tell all of your doctors and your dentist that you have a device in your valve. This is important because you may need to take antibiotics before certain procedures to prevent infection.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia will likely make you sleep. You won't feel pain when the catheter is put in the blood vessel.
• The procedure will take about 3 to 4 hours.

After the procedure

• After the procedure, pressure may be applied to the area where the catheter was put into your blood vessel. This will help prevent bleeding. A small device may also be used to close the blood vessel. You may have a bandage or a compression device on the catheter site.
• You will need to lie still and keep your leg straight for up to a few hours. A weighted bag may be put on your leg to help you keep it still.
• Your care team will check your heart rate and blood pressure. They will also check the catheter site for bleeding.
• You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away.
• For a while after the procedure, you'll have a catheter in an artery in your arm. It is used to check your blood pressure and take blood samples.