James Young - MitraClip Patient - UM St. Joseph Sandra R. Berman Heart Institute

A Transcatheter Interventional Technique for Mitral Valve Repair Offered at University of Maryland St. Joseph Heart Institute Helps Patients Avoid Open-heart Surgery

James Young is an active, 86-year-old former athlete who was a world championship softball player and played polo. He works out on his exercise equipment several times a week and runs a high-end upholstery business that he describes as “old-world.”

But he felt like his world of good health turned upside down when he sought care at a local health center for symptoms of severe fatigue, weakness and shortness of breath. He ended up being transported from there by ambulance to The Sandra R. Berman Heart Institute at University of Maryland St. Joseph Medical Center for cardiac care.

“I requested St. Joseph in Towson because I knew the reputation of their heart center,” Young said.

At UM St. Joseph, Young was seen in the Emergency Department by board-certified cardiologist Daniel Plotnick, MD. Dr. Plotnick diagnosed Young with functional mitral valve regurgitation, which meant that his heart’s mitral valve was leaking blood back into the heart’s left atrium and into his lungs. Dr. Plotnick put Young on medication management, but then an opportunity came up for a unique minimally invasive heart procedure to repair his mitral valve.

A First at the Heart Institute

Fortunately, board-certified interventional cardiologist Daniel Ambinder, MD, who had performed many such procedures, was preparing to do the first one at UM St. Joseph. Young’s competitive, athletic spirit motivated him to want to be the first patient.

“My quality of life was going to continue to deteriorate,” said Young, who discussed the procedure with the heart team and was impressed.

There are two types of mitral valve regurgitation: degenerative (primary), in which the valve becomes loose over time, and functional (secondary), often caused by heart failure.

In August 2022, a special mitral valve repair device was approved by the Food and Drug Administration for secondary mitral valve regurgitation.

A Small Clip Fixes the Valve

Dr. Ambinder explained that the repair procedure involves accessing the femoral vein in the groin area using catheters and wires. Fluoroscopy and transesophageal echocardiography are used to guide the entire process, providing real-time, detailed images of the heart and internal structures. Then a clipping device (MitraClip) about the size of a dime is delivered and deployed in the mitral valve position, clasping together the valve’s two leaflets, which significantly reduces the amount of regurgitant or leaky blood flow.

“Mr. Young’s clinical outcome was excellent, and he likely derives significant benefit from the technology,” Dr. Ambinder said.

“I am very happy with the operation,” Young said. “It amazes me. I felt fine immediately afterward. It was fantastic that I only had a one-night stay and returned to work in just one week.”

The success of the procedure relies on the collaboration of a specialized multidisciplinary heart team focused on delivering exceptional patient care. They include interventional and structural cardiology, cardiac surgery with a strong surgical mitral valve program, cardiac anesthesiologists and imagers, a dedicated valve coordinator, and nursing and technologist teams.

“This procedure is an excellent option for patients with primary mitral regurgitation who are at high risk for open-heart surgery for valve replacement.”

—Daniel Ambinder, MD, Interventional Cardiologist at the Sandra R. Berman Heart Institute at UM St. Joseph