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An innovative procedure to repair leaking heart valves without the need for invasive surgery has been carried out at St Bartholomew’s Hospital for the first time in the UK, giving hope to patients suffering from mitral regurgitation who are deemed high risk for surgery.

Mitral regurgitation is a condition where weakness in the heart muscle causes the mitral valve to stretch and leak. As a result of this leaking, some blood flows the wrong way and the heart has to work harder to pump this extra blood, which over time can be life threatening.

Experts at the Barts Heart Centre – the biggest heart centre in the UK – have successfully performed the UK’s first Transcatheter Mitral Valve Repair (TMVr) procedure with a device called a Cardioband to treat this potentially deadly condition.

The Cardioband is a new technique that emulates the surgical operation in that a band is attached to the orifice of the mitral valve using multiple screws and then tightened to shrink the orifice, reducing the amount of leakage. However, this innovative procedure now allows interventional cardiologists to reach the heart and repair the valve non-invasively through a small tube, known as a catheter, which is inserted into a vein at the groin.

Until now, some patients suffering from mitral regurgitation have had to live with their symptoms due to being ineligible or too high risk for surgery or their medical management not being effective. This new procedure means there is now hope for such patients suffering with the debilitating condition.

The procedure can be carried out in one to three hours and should result in shorter hospital stays and quicker recovery times for patients compared with those who have surgery.

Mitral regurgitation is a growing concern in the UK as we have an ageing population and the chances of developing the condition increase with age. In severe cases blood doesn’t move through the heart or to the rest of the body efficiently, causing people to experience breathlessness, fatigue, dizziness, chest pain or heart palpitations and swollen feet or ankles. If left untreated, it can lead to heart failure and death. 

70 year old Richard Pepper, who developed heart failure and severe mitral regurgitation after suffering a heart attack in 2014, is the first person in the UK to have undergone this TMVr Cardioband procedure. 

Richard said: “Before this procedure, my condition was completely debilitating. My body was holding onto large amounts of fluid, which was not only painful but caused me to gain a lot of weight. I also became breathless very easily and needed to spend most of my time sat down. Simple daily tasks weren’t so simple anymore.

“Before my heart attack, I was a fit and active person. I loved being outdoors and playing sports. I played football until the age of 55 then turned to cycling and swimming as a means of keeping fit. So it has been very difficult to come to terms with the impact of having a heart attack at 67.”

Last year as his symptoms worsened, Richard was referred by Broomfield Hospital Consultant Cardiologist Dr Onkar Dhillon to St Bartholomew’s Hospital where the UK-first Cardioband TMVr procedure was performed.

Richard added: “My consultants at St Bartholomew’s Hospital, Dr Michael Mullen and Dr Simon Kennon, assessed me thoroughly. They were confident the damage to my heart valve could be rectified better with this new procedure. They took the time to talk me through how the procedure works and explained that I would be the first person in the UK to have it done. This was a shock at first, but I had complete faith in the team, so decided to go for it. The team’s professionalism was exceptional and they made sure I felt comfortable and informed throughout my time at the hospital.

“I was discharged from St Bartholomew’s after just a few days. I feel I am recovering well, and despite the procedure only taking place a few weeks ago, I already feel much better. I’m no longer spending my days completely breathless and slumped in an armchair. It’s been lovely to spend some time out in my garden again.

“I feel like I’ve got my mojo back and I can’t thank the wonderful team at St Bartholomew’s enough for what they have done for me. I feel hopeful for the future now.” 

Dr Michael Mullen, Consultant Cardiologist at Barts Health NHS Trust said: “Typically patients like Richard would need surgery, but this new technique means we have been able to achieve the same result whilst avoiding the need for open heart surgery.

“The team and I successfully tightened the Cardioband device around Richard’s heart valve to reduce the amount of leak and help blood flow in the right direction through the heart. Richard was able to go home within a few days with a short recovery and is already noticing the benefits of this procedure. This represents a significant step forward in our ability to treat patients with this condition.”

Dr Simon Kennon, Consultant Cardiologist at Barts Health NHS Trust said: “It is hugely beneficial for us to have more options available to treat patients with heart conditions like Richard. We are delighted that he has felt immediate benefits from the Cardioband procedure.  

“We will need to wait to see the full impact of the Cardioband,  as tissue needs to grow around the device to strengthen it, but we couldn’t be happier with the initial results. We look forward to welcoming Richard back to St Bartholomew’s for his follow-up appointments.”