Re-Repairing a Mitral Clip: What Should Patients Know?
Written By: Allison DeMajistre, BSN, RN, CCRN
Medical Expert: Marc Gerdisch, MD, Director of Minimally Invasive Cardiac Surgery, Indiana University Health, Indianapolis, Indiana
Reviewed By: Adam Pick, Patient Advocate, Author & Website Founder
Published: October 8, 2026
A mitral valve clip, also known as a MitraClip, is a small metal clip designed to reduce mitral valve regurgitation. The small, staple-like clip grasps the two mitral valve leaflets and brings them together to improve valve closure and prevent leakage. Since FDA approval in 2013, thousands of patients with mitral regurgitation have experienced long-lasting symptom relief from the innovative device. It can be an excellent minimally invasive solution for patients with severe mitral regurgitation who aren’t good candidates for traditional open-heart surgery. That said, it's not a permanent solution for everyone, and its longevity can vary depending on patient-specific factors; patients often want to know what happens if the clip fails and the regurgitation returns.
We received a great question from Mary about this topic. She asked, “I had a mitral clip procedure five years ago. It is now starting to degrade, and I have moderate mitral valve leakage. What is the best option for a healthy 82-year-old?”
To answer Mary’s question, Adam Pick, founder of HeartValveSurgery.com, met with Dr. Marc Gerdisch, Director of Minimally Invasive Surgery at Indiana University Health in Indianapolis, Indiana. Dr. Gerdisch has performed more than 7,000 cardiac surgeries and specializes in advanced heart valve repair techniques using minimally invasive approaches.
Video available online at:
https://www.youtube.com/watch?v=0uRXfwFIhGM
Mitral Valve Re-Repair and What Patients Should Know
Here are the key insights shared by Dr. Gerdisch:
FDA indication for the MitraClip and long-term issues. Dr. Gerdisch said, “This issue has cropped up in the last several years since the MitraClip came on the scene.” He explained that the FDA indication for the clip is mitral valve regurgitation due to a change in heart structure caused by poor left ventricular function. Some patients with mitral regurgitation not caused by a change in heart structure also got the MitraClip, which is outside of the FDA indication. “Because there’s nothing else wrong with them, they live for a long time, and they have to deal with some issues.”
Some patients may need replacement instead of repair. “We published a paper on minimally invasive heart surgery for people who already have the clip, and last year we presented a video on how to remove a clip and re-repair the valve. Unfortunately, if we look at all patients, we can remove the clip and re-repair the valve only 40 or 50 percent of the time because the clip becomes scarred in and heals to the leaflets. So, it’s often a replacement instead of a repair. For Mary, at 82, that might not have as much consequence, and it might be okay to replace the valve. In this case, though, I would do what we do for anyone with mitral valve disease: a minimally invasive mitral valve repair or replacement. We could look to re-repair, but may have to replace it because of the clip. I think we will have to deal with this more over time.”
Dr. Gerdisch’s advice for Mary. “If Mary has a moderate leak, the heart muscle looks good, and the leak is genuinely moderate, then it should probably be left alone. If it becomes severe, if the ventricle changes shape, if she develops atrial fibrillation, gets pulmonary hypertension, or any of the hallmark problems that we see in mitral insufficiency, then the valve should be treated surgically.”
Thanks, Dr. Gerdisch and Indiana University Health!
On behalf of all the patients in our community, thank you, Dr. Marc Gerdisch , for everything you and your team are doing at Indiana University Health in Indianapolis, Indiana.
Related links:
Keep on tickin,
Adam
P.S. For the deaf and hard-of-hearing members of our patient community, we have provided a written transcript of our interview with Dr. Gerdisch below.
Written by Adam Pick
Patient & Website Founder
Written by Adam Pick - Patient & Website Founder
Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.
Video Transcript:
Adam Pick: Hi everybody. It's Adam with HeartValveSurgery.com, and we're at the Endoscopic Cardiac Surgeon's Club in Northern Kentucky. I'm thrilled to be joined by Dr. Mark Gerdisch, who is the Director of Minimally Invasive Surgery at Indiana University Health in Indianapolis, Indiana. Dr. Gerdisch, you and I have known each other for over 15 years. It is great to see you again.
Dr. Marc Gerdisch: Thank you Adam. It has been quite a while. It goes quickly though. It really does.
Adam Pick: And so we're here at this conference. We're learning a lot. You're getting ready to give a presentation all about atrial fibrillation and heart valve disease, but we're also getting questions from patients all over the world.
And this one comes in from for you, from Mary, and she asks. I had a mitral clip procedure five years ago. It is now starting to degrade, and I have moderate mitral valve leakage. What is the best option for a healthy 82-year-old?
Dr. Marc Gerdisch: This is something that's kind of cropped up for us over the last several years because the MitraClip came on the scene and, uh, some folks, um.
We're getting it for the FDA indication, which is in a patient who has poor left ventricular function and has a mitral valve that doesn't function normally because of the change in the heart, the ventricle. So that's the actual FDA indication for the, for that device. But then some patients have gotten it kind of outside of that indication, and that would be somebody like what this sounds like where the patient just has mitral valve disease and they get the clip, uh, and then.
Because they're, there's nothing else wrong with them. They live for a long time and then they're going to deal with some issues. So, uh, we’ve published a couple times on this. Uh, we did a, we published a, a paper on minimally invasive, uh, heart surgery for people who already have had the clip. And, uh, last year we presented a video on how to remove a clip and re-repair the valve.
Unfortunately, if we look at all the patients that we have to deal with the clip. Later in the game, we have to deal with it, uh, surgically only about 40% of the time. It might be 50% that we can get the clip off and re-repair the valve because the clip becomes very scarred in and heals to the leaflets.
So often it's going to be a replacement, obviously instead of a repair. At 82 years of age that might not have as much consequence. In other words, it might be okay to get the valve replaced, but I would say that most likely in this case, we would do what we do for. Any other person who has mitral valve disease, which would be a minimally invasive mitral valve repair or replacement, and we would look at it to re-repair it.
We might have to replace the valve though, because of the mitral valve clip. So, this is something I think that's going to come up, you know, more and more over time right now, if she has a moderate leak and the heart muscle looks good. And it's genuinely moderate, then it should probably be left alone. But when the time comes, if it becomes severe, if the ventricle changes shape, you should develop atrial fibrillation, gets pulmonary hypertension. Any of the things that we look at as hallmarks of a problem with mitral insufficiency, then the valve should be treated surgically.
Adam Pick: Great. Mary, I hope that helped you and Dr. Gerdisch. Thanks for shining the light on some of the considerations for the lifetime management of mitral valve disease. And as always, thanks for everything you and your team are doing at Indiana University Health.
Dr. Marc Gerdisch: Thanks, Adam.
New Patient Posts
Adam's Video Library
Learn about heart valve surgery and patient success stories at Adam's video library.
