A “life changing” procedure for one of the most common heart complaints will now be available in Scotland after a 10-year battle by doctors to see it funded by the NHS.

Trans-catheter edge to edge repair (TEER) is a “straightforward” solution to a condition that affects hundreds of thousands of people across the UK.

Until now, open heart surgery has been the only option available for patients with a leaky mitral valve, which if left untreated can lead to blood clots, stroke and heart failure.

The two-hour procedure is performed using keyhole surgery in which doctors access the mitral valve with a catheter guided through a vein in the patient’s groin.

One or more implanted clips are attached to the mitral valve to seal off the leak and retore normal blood flow.

The majority of patients are mobile within a day and can leave hospital shortly after. 

The Herald:

In one case a patient who  had been in intensive care for 11 weeks was discharged from hospital within a week after having the TEER repair.

Around 70% of patients find that symptoms including breathlessness get better after the procedure and are able to return to everyday activities such as walking up stairs and going for a stroll.

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The mitral valve has two leaflets that open and close to allow blood to flow through the heart.

If you have been diagnosed with mitral valve regurgitation, it is because your heart’s mitral valve is not closing tightly enough, which allows blood to flow in the wrong direction. 

The Herald:

When blood is not flowing through the heart as it should, it can cause you to feel tired and weak, and in severe cases, may lead to heart failure, arrhythmia (heart rhythm problems) or more serious complications.

The problem often develops with age as a result of wear-and-tear or damage caused by untreated high blood pressure.

However, mitral stenosis can present in young patients after bacterial infection of the heart or in elderly patients due to deposition of calcium on the mitral valve.

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Delays in NHS funding have left the UK lagging behind other European countries in access to TEER with Germany performing 50 times more procedurers.

The NHS decided not to fund the treatment in 2011 but heart doctors have been pressing for the decision to be reversed.

A two-year evaluation was carried out to prove its effectiveness but the decision was delayed due to the pandemic.

A total of 20 hospitals across the UK will now offer the procedure including the Golden Jubilee hospital in Clydebank, which is Scotland’s national heart and lung centre.

The Herald:

Each centre could perform up to 50 procedures every year, which could lead to hundreds of patients benefitting including those who are unable to undergo open heart surgery.

The incidence of heart valve disease increases significantly with age.

Degenerative abnormalities associated with severe aortic stenosis and mitral and tricuspid regurgitation are found in not less than 10% of the population aged over 75.

Surgical treatment has been considered for years to be the treatment of choice. 

However, it was not uncommonly associated with high peri-operative morbidity and mortality due to frequent co-morbidities and overall frailty of patients. 

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At least 30% of patients with severe conditions are left untreated due to surgical risk.

Professor Dan Blackman, interventional cardiologist at Leeds Teaching Hospital’s NHS Trust told The Telegraph:  “This is a life-changing and life-saving procedure.

“One of the most dramatic results I have seen was a patient who was in hospital for 11 weeks, and was stuck on the intensive care unit, critically ill.

“After we performed Teer  he was discharged from hospital in just a week.

“That was a remarkable outcome and highlights just how effective this straightforward procedure can be.”