Swedish research at the forefront of new advances in heart health

January 31, 2019

Swedish Blogger

A recent clinical trial at Seattle's Swedish Heart & Vascular Center finds promising results for treating leaking heart valve in certain patients.

Swedish participated in an important study on treating leaking mitral valve.
The MitraClip device used in the study is a less-invasive procedure than traditional heart surgery.
The MitraClip helps improve quality of life for patients whose leaky valve is caused by a diseased heart muscle, their heart doesn’t squeeze properly and they already have received optimal medical treatment.

Often, the field of medicine takes great strides within the context of clinical trials. Intensive, in-depth research can lead to new treatments, medications, surgical procedures or medical devices that have been tested for safety and efficacy. Recently, Swedish participated in one such trial that may make a difference in how to treat a certain type of heart issue.

Swedish was the only organization in Washington state to take part in a trial that focused on a leaking mitral valve. This valve is the inlet valve to the left ventricle, the heart’s main pumping chamber. Left unchecked, this can lead to arrhythmia or heart failure.

Historically, fixing a leaking mitral valve used to involve heart surgery, but a device called MitraClip offers a less-invasive way of treating this valve. The study — Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) Trial — delivered encouraging results for more widespread use of the MitraClip, as well as the importance of addressing the topic of leaking heart valves.

With the MitraClip, the procedure is catheter-based. The device itself is delivered via catheter through a blood vessel in the leg and up to the heart valve guided by ultrasound and x-ray imaging. The MitraClip acts like a staple for the valve, says John L. Petersen II, MD, a cardiologist at the Swedish Heart & Vascular Institute.

“The clip can be opened and closed, so it can grab the front and back leaflets of the mitral valve to fix the leak,” he says. “We can then leave the clip in, take the rest of the equipment out and we can assess the reduction in leaking during the procedure.”

The COAPT trial was important not just for studying the MitraClip, but for studying leaking heart valves in general, Dr. Petersen says. It was particularly designed to look at patients whose hearts were not squeezing well and for whom a leaking valve was a component of that problem. The goal was to find out if treating the leak was important to the patient’s overall outcome, in terms of living longer and a reduced risk of future hospital visits.

“It wasn’t necessarily just about the question of whether we put a clip on every heart valve that is leaking. It was more about an additional approach to how we care for these types of patients even in a setting in which they’ve received the optimal medical treatment such as medication, which is an important part of the trial,” he says. “Does repairing a heart valve in a patient who has a sick heart help them live longer, especially if the leak was caused by a muscle that was diseased? No one really knew the answer to that prior to this trial.”

The fundamental answer is a resounding yes, which is why the COAPT trial is important, Dr. Petersen says. Swedish participated in the trial because it had been using MitraClip longer than any other organization in Washington state. “We have a robust structural heart program led by Dr. Sameer Gafoor,” Dr. Petersen says. “We had participated in earlier studies with the MitraClip even before it was initially approved for primary mitral regurgitation in the U.S. in 2013, so we were asked to participate in the COAPT study which examines MitraClip use in treating secondary mitral regurgitation.”

Swedish’s involvement in these types of clinical trials marks it as an exemplary health organization, Dr. Petersen adds.

“There are several things that highlight us as an outstanding medical center,” he says. “We have cutting-edge technology and can deliver newer things to patients that many other medical centers cannot. It also speaks to the types of patients and physicians we have who are able to participate in these studies. It distinguishes us as an organization that does more than deliver high-quality health care. We actually participate in developing the new therapies that are coming.”

Learn more about Swedish’s Structural Heart and Valve Disease program. To connect with Swedish providers, book an appointment online or visit our directory.

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