Heart Valve Summit Video #2: Discussing Catheter-Based Mitral Valve Surgery With Dr. Steven Bolling
By Adam Pick on October 19, 2012
Patient interest specific to transcatheter aortic valve implantation is very, very, very high. However, patients with mitral valve disorders, including mitral regurgitation, are wondering, “What about me? Are there any catheter-based solutions for mitral valve surgery?”
To answer that question, I interviewed Doctor Steven Bolling at the Heart Valve Summit. So you know, Dr. Bolling is the Director of the Mitral Valve Clinic at the University of Michigan. During his career, Dr. Bolling has performed over 3,000 mitral valve procedures. (If you are hearing impaired, a written transcript of this interview is provided below.)
Thanks to Dr. Steven Bolling, MD for taking the time to share his clinical research and experience with our community!
Also, as a technology enthusiast, I will continue to monitor the latest devices that will enhance heart valve treatment. To get my updates, you can join my free newsletter by clicking here.
Keep on tickin!
P.S. Here is the written transcript of my conversation with Dr. Bolling.
Adam: Hi everybody! It’s Adam with HeartValveSurgery.Com. We are here in Heart Valve Summit in Chicago, Illinois and I am thrilled to be joined by Dr. Steven Bolling, who is the Director of Mitral Valve Clinic at the University of Michigan. Dr. Bolling and I were just having a conversation about technology. The patients are hearing a lot about TAVI, Transcatheter Aortic Valve Implantation and they are wondering, “What about the mitral valve?” Because TAVI is all about aortic valve. Are there any catheter-based solutions for mitral valve surgery?
Dr. Steven Bolling, MD: Well Adam, thanks for having me here to talk with you. That’s a very interesting question. Is there going to be a future, a soon future, for mitral valve percutaneous devices. As you know the aortic valve is really just a door. When we surgically replace the aortic valve we put in a new door so we learn how to do that percutaneously. But, the mitral valve is really not just a valve but it’s an apparatus. It’s very complex and at surgery, when we repair the valve — which is of course our aim for all patients to repair it — we do one of 27 things maybe to fix that valve. So, the complexity behind fixing a mitral valve are far more than how we approach the aortic valve. So it is not surprising that mitral valve percutaneous technology is lagging far behind aortic percutaneous technology.
Adam: In terms of the percutaneous we are hearing about some companies and some technologies. Two that I’ve heard of are, the Mitraclip and Mitralign. Can you share where those technologies are right now and where they may be going in the future?
Doctor Bolling: So right now, there really only is one that is used clinically. That’s the Mitraclip device which imitates the surgical technique called the Alfieri stitch which really binds the two leaflets together. That is one of numerous techniques that we use during mitral valve repair. I think the MitraClip will become a tool for certain group of people. In the pipeline there are many other different mitral percutaneous techniques for repair. They are going to come up, each one of them, sort of mimicking something we do in surgery to do repair the mitral valve. These are going to take a long time to get where we want them to be.
Adam: I guess the big question is, in terms of mitral valve replacement percutaneously, that sounds like it’s away off in terms of time for clinical use.
Steven Bolling, MD: Adam, you are absolutely right. Mitral valve replacement in a percutaneous manner is many years in the future. The complexity of landing a valve in the mitral position by a catheter is very difficult. If you were to ask me which one would go first. I would tell you aortic first… Then, mitral valve 20 years from now.
Adam: Dr. Bolling thank you so much for taking the time to meet with us today share this information specific to percutaneous mitral valve surgery. On behalf of all your patients, many have come to our website, being Jeff Adams, David Dubay and Elizabeth Nolton for example I would like to thank you for really fixing them.
Doctor Steven Bolling: Thanks for having me here.