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Treatment of Mitral Valves

Mitral Valve Regurgitation

The second most common valvular disease in adults is mitral valve insufficiency / mitral valve regurgitation. Several surgical techniques have been developed to repair or replace a diseased mitral valve. However, some patients have a very high surgical risk. Different catheter based methods are available to treat the mitral valve without major surgery.


MitraClip Implantation

An interventional technique in the cardiac catheterization lab can be used for a non-surgical treatment of this disease. A mitral valve clip (MitraClip) can be inserted into the left heart via the femoral vein (in the groin) and a puncture of the atrial septum. The clip can be advanced to the left ventricle and then be pulled back from the left ventricle into the left atrium, thus catching the mitral valve leaflets on the open clip arms The clip may then be closed, and therapeutic success will be immediately analyzed by ultrasound. This procedure requires general anesthesia, but no surgery. The patients recover quickly and can be mobilized next day.  

A MitraClip has been fixed to both leaflets of the mitral valve, and is still attached to the delivery catheter (view from the left atrium).

A MitraClip has been fixed to both leaflets of the mitral valve. The delivery catheter has been removed (lateral view). 

At the University Hospital Heidelberg we have many years of experience with MitraClip implantations, both in patients with severe heart failure as well as in patients with degenerative mitral valve disease and high surgical risks. We have also performed this procedure in patients with prior surgical mitral valve repair. Even in children we have performed successful MitraClip implantations, if surgery was impossible. The youngest patient worldwide (9 years old) has been implanted with a MitraClip at our institution together with our pediatric cardiologists.


Interventions in degenerated surgical bioprostheses

Surgically implanted mitral valve bioprostheses can degenerate with time, causing stenosis or insufficiency. A new surgical valve replacement may be too risky. These patients can receive a transfemoral balloon expandable bioprosthesis via the groin into their degenerated prosthesis, a so called “valve-in-valve” implantation. At the University of Heidelberg we have experience with several such procedures. The worldwide second transfemoral valve-in-valve implantation in a mitral bioprosthesis has been performed at our institution.


Implantation of a balloon expandable valve in a degenerated mitral valve prosthesis via transfemoral vein and transseptal puncture


Mitral valve research at the University of Heidelberg

As an academic institution and to control our quality and help improving new techniques, our mitral valve program has always been accompanied with scientific projects. Some of the work that we have done, or the work where we have contributed to international studies, can be found below.


Initiates file downloadMitral valve research at the University of Heidelberg

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Mitral Valves

PD Dr. Sven Pleger

PD Dr. Philip Raake



Klinik für Kardiologie, Angiologie und Pneumologie

Im Neuenheimer Feld 410

69120 Heidelberg

Tel.: +49 6221 56-8676

Fax: +49 6221 56-5515