Transcatheter Mitral Valve Replacement

Transcatheter mitral valve replacement
Table of Contents

When it comes to sophisticated cardiac care, experience matters. MK Heart Clinic combines world-class facilities with our experienced specialist – Dr. M. Kathiresan, the best interventional cardiologist in Chennai to provide advanced transcatheter mitral Valve replacements. 

What is a TMVR Procedure?

Transcatheter Mitral Valve Replacement (TMVR) is a surgical procedure that is performed by an interventional cardiologist to replace the mitral valve in your heart. It is considered to be a less invasive alternative to open-heart surgery especially for patients with mitral valve disease. The new valve that is replaced does the work of the faulty or defective mitral valve.

Who Needs to Have TMVR?

The mitral valve is one of four heart valves that helps the blood to flow in the correct direction. This valve exists between the two left chambers of your heart, the left atrium and left ventricle.
It also has two flaps called leaflets which open and close during every heartbeat and when functioning properly it facilitates one-way direction of forward blood flow.
Sometimes, people who are born with or develop problems with their mitral valve, such as:

  • Mitral Valve Regurgitation – The valve doesn’t close properly and can cause blood leakage backward.
  • Mitral Valve Stenosis – The valve narrows or gets blocked and doesn’t open as wide as it should preventing adequate forward blood flow.

Severe cases of mitral valve diseases cause symptoms, including pulmonary hypertension, atrial fibrillation, or heart failure. Transcatheter mitral valve replacement can be an option for some people who are prone to mitral valve disease and who are not considered to be good candidates for open-heart surgery.

Transcatheter mitral valve replacement | Dr. M. Kathiresan

When and How is it Performed?

TMVR is typically performed in cases where the patient is at high risk or not suitable for traditional surgical mitral valve replacement due to various reasons such as age, frailty, or multiple comorbidities.
The procedure of transcatheter mitral valve replacement in Chennai is performed in a cardiac catheterization lab by a team of interventional cardiologists and cardiac surgeons. The procedure begins with the patient being placed under general anesthesia to ensure they are comfortable and asleep throughout the procedure.

Next, the physician makes a small incision in the groin or chest to access the blood vessels. Using fluoroscopy and echocardiography guidance, a catheter is threaded through the blood vessels and into the heart, and a prosthetic valve is delivered to the site of the damaged mitral valve.

There are several different techniques for transcatheter mitral valve replacement in Chennai, depending on the specific prosthetic valve being used and the anatomy of the patient’s heart. One common approach is called transseptal, where the catheter is passed through the septum, the wall that separates the left and right atria of the heart.

In a transapical approach, small incisions are made in the chest. Then a catheter will be inserted directly into the apex of the heart. The chosen approach will depend on the patient’s condition and the surgeon’s preference.

Once the prosthetic valve is in position, it is expanded using a balloon or a self-expanding mechanism, which anchors it securely in place, replacing the damaged mitral valve. The catheter is then removed, and the incisions are closed. The patient is monitored closely in the cardiac catheterization lab and then moved to a recovery room for observation.


What Happens Before the TMVR Procedure?

Before TMVR, certain tests such as an echocardiogram and CT scan are conducted by the best interventional cardiologist in Chennai to plan the treatment procedure. The patient will also meet with a specialist to determine the type of anesthesia – general anesthesia or conscious sedation to prevent pain during the performance of the procedure. 

Then specific instructions will be given on how to prepare for TMVR. They may include:

  • Avoid taking certain medications a few days prior the procedure.
  • Avoid food and water on the procedure day. 

What Happens During TMVR?

The transcatheter mitral valve replacement takes about 2- 3 hours. It requires a team of specialists, including cardiac surgeons,  interventional cardiologists, imaging specialists and anaesthesiologists. 

  • The treatment area where the procedure will take place will be shaved and cleaned.
  • A soft, flexible tube (intravenous line or IV) is inserted into a vein in the patient’s arm to deliver medications and fluids.
  • A human-made valve is placed onto the end of a catheter which is a thin, flexible tube.
  • Then an incision is made in the groin or chest, to insert the catheter into a blood vessel.
  • Using imaging technology the catheter is guided to the mitral valve.
  • The new valve is positioned and secured inside the existing valve.
  • Then the catheter is removed and the incision is closed. 

During the procedure, the best interventional cardiologist in Chennai continuously monitors for vital signs, including blood pressure and blood oxygen levels. Also, the heart is monitored with echocardiography to capture pictures of the valves and chambers.

What Happens After TMVR?

After transcatheter mitral valve replacement, the patient will be taken to the recovery room. Some people may have to be in observation in the intensive care unit for a short while, but most people require a hospital stay for a few days.

Specific instructions regarding cardiac rehabilitation, starting or restarting medications, follow-ups, along with dietary changes will be provided to help the patient restore to a normal lifestyle. 

Advantages of TMVR

The transcatheter approach to heart valve surgery.

  • Helps correct mitral valve disease.
  • Improves symptoms caused by mitral valve disease.
  • Reduces the risk of serious health problems.
  • Provides a speedy recovery than open-heart surgical options.

Risks or Complications of TMVR

Although Transcatheter mitral valve replacement, has fewer risks than open-heart surgery, certain complications that may occur includes,

  • Blood clots.
  • Damage to tissues.
  • Left ventricular outflow tract obstruction.
  • Migration or movement of the valve out of position.

The interventional cardiologist may decide to change the procedure to an open-heart surgery if required. Some complications might require a second procedure.

Transcatheter Mitral Valve Replacement: Symptoms and Indications

Transcatheter Mitral Valve Replacement (TMVR) is a specialized procedure to address mitral valve issues without open-heart surgery. While symptoms may vary, indicators for TMVR typically include:

  • Mitral Valve Regurgitation: TMVR is commonly employed for severe mitral valve leakage.
  • Heart Failure Symptoms: Persistent fatigue, shortness of breath, and fluid retention.
  • Limited Surgical Options: Patients deemed high-risk for traditional surgery may opt for TMVR.

Consulting with a cardiologist helps determine if TMVR is a suitable intervention based on individual symptoms and overall health.


To summarize, at MK Heart Clinic the patients who have undergone Transcatheter mitral valve replacement under the guidance of Dr. M. Kathiresan, the best interventional cardiologist in Chennai can resume their work and other activities several weeks after the procedure but a complete recovery may take about 2-3 months. 

Also Read: What is TAVR? Why it is Important?

Frequently Asked Questions

Considering the proper patient selection as well as the timely intervention, the success rate of transcatheter mitral valve replacement is estimated around 95%. Almost 95% of patients need not undergo second operation or reoperation for 10 years and about 90% of patients do not require reoperation for mitral valve repair. 

Yes, a mitral valve replacement can be done without undergoing open-heart surgery. Instead, a minimally invasive procedure – The Transcatheter Mitral Valve Replacement (TAVR) is performed using a catheter. This can also be a better choice for patients who are moderate to high-risk complications from open heart surgery, mitral valve regurgitation or stenosis

The approximate cost of TMVR or Transcatheter Mitral Valve Replacement in Chennai, India, ranges from INR 3,00,000 to INR 8,00,000 (Indian Rupees). Please note that actual costs may vary and it’s best to consult with a qualified healthcare provider or a cardiologist for accurate and up-to-date information.