Inova Heart Team Tests New, Minimally Invasive Option to Replace Leaky Mitral Valves

Matthew W. Sherwood, MD, MHS, is board certified in interventional cardiology, cardiovascular disease and internal medicine. He practices at the Inova Heart and Vascular Institute. 

The Inova Heart and Vascular Institute has a long history as a leader in treating heart disease. True to that mission, we’re excited to offer an innovative new treatment for patients with mitral valve disease.

Last week, our structural heart team successfully treated our first patient using a new technology to replace faulty mitral valves. Until now, open-heart surgery was the only option for replacing this heart valve. We’re thrilled to begin offering our patients a less invasive alternative, known as transcatheter mitral valve replacement (TMVR).

Treating Mitral Valve Regurgitation

When the mitral valve works correctly, blood flows through it from one chamber of the heart (the left atrium) into another chamber (the left ventricle). In people with a defective or damaged mitral valve, blood leaks backward into the atrium.

Mitral valve disease can cause a variety of symptoms, including fatigue, dizziness, lightheadedness, chest pain, shortness of breath and a racing or irregular heartbeat. In serious cases, the disorder can lead to heart failure.

Sometimes, we can manage the condition with medications, or repair the leaky valve with a device called MitraClip. In more severe cases, we must replace the faulty valve with an artificial one. Traditionally, that’s been done with open-heart surgery.

Now, as part of a global trial known as the Medtronic APOLLO Trial, our team is treating patients using a device called the Intrepid™ TMVR. With this technique, we make a small incision in the chest wall. Then we insert a small tube, or catheter, into the heart. A new valve is passed through the catheter and into position in the heart.

This approach to mitral valve replacement may lead to shorter recovery times and fewer complications compared to patients who undergo traditional open-heart surgery. It is one of only a few options for patients too ill to have open-heart surgery.

APOLLO: Who is Eligible?

Inova’s structural heart team is already highly experienced in procedures of this type. We are leaders in a similar technique called transcatheter aortic valve replacement (TAVR), which replaces a different heart valve without cutting into the chest. We also perform a type of TMVR to replace artificial mitral valves that have worn out. But until now, the only way to replace a natural valve was with open-heart surgery.

Thanks to our strong experience in treating structural heart disease, Inova was chosen to participate in the APOLLO trial along with other leading heart centers around the world.

In one arm of the trial, we’re enrolling patients who are candidates for open-heart mitral valve replacement. Half will be randomly assigned to receive TMVR, while the others will have the conventional open-heart surgery. At the end of the study, the research team will compare patients’ outcomes.

At the same time, we’re also enrolling patients who aren’t candidates for open-heart surgery because their health problems make surgery too risky. This is the first transcatheter mitral valve replacement option for such high-risk patients.

The cardiologists and surgeons at the Inova Heart and Vascular Institute are dedicated to providing state-of-the-art care to every patient. Participating in clinical trials is one way we’re fulfilling that mission.

For more information about the APOLLO trial, call 703-776-6007 or read more about the current clinical trials at the Inova Heart and Vascular Institute.

The Structural Heart Disease Team at Inova Heart and Vascular Institute includes:

• Interventional Cardiologists:
  • Matthew Sherwood, MD
  • Shawn Yazdani, MD
  • Nadim Geloo, MD
  • Kelly Epps, MD
  • Joseph Kiernan, MD
  • Hamid Taheri, MD
• Cardiothoracic Surgeons:
  • Eric Sarin, MD
  • Liam Ryan, MD
  • Alan Speir, MD