CPT® Code 0345T

1. Indications

The transcatheter mitral valve repair procedure is indicated for patients experiencing mitral valve regurgitation (MVR) due to ineffective closure of the mitral valve leaflets. This condition can lead to significant clinical symptoms and complications, necessitating intervention. The following are specific indications for this procedure:

• Mitral Valve Regurgitation (MVR) - A condition where the mitral valve fails to close properly, allowing blood to flow backward into the left atrium from the left ventricle.
• Heart Failure Symptoms - Patients exhibiting symptoms of heart failure, such as shortness of breath, fatigue, and fluid retention, may benefit from this repair.
• Severe Mitral Valve Dysfunction - Patients with significant mitral valve dysfunction that impacts their quality of life and overall cardiac function.

2. Procedure

The transcatheter mitral valve repair procedure involves several critical steps to ensure successful implantation of the device. The following outlines the procedural steps:

• Step 1: Vascular Access - The procedure begins with establishing vascular access through a percutaneous approach via the femoral artery. This minimally invasive access point is crucial for the subsequent steps of the procedure.
• Step 2: Catheter Advancement - Once access is secured, a guide catheter is advanced into the coronary sinus. This step is performed under imaging guidance, utilizing fluoroscopy or ultrasound to ensure accurate placement.
• Step 3: Delivery of the Implant - A delivery catheter containing the implant is threaded through the guide catheter to the targeted site within the coronary sinus. This step requires precision to ensure the device is positioned correctly for optimal function.
• Step 4: Device Deployment - The device is deployed into the coronary sinus. It features self-expanding anchors at both the proximal and distal ends of a spring-like bridge. As the device is deployed, these anchors shorten and draw the proximal coronary sinus and distal great cardiac vein closer together.
• Step 5: Mitral Valve Adjustment - The action of the device effectively displaces the posterior mitral annulus anteriorly. This adjustment allows the mitral valve leaflets to approximate more closely, thereby reducing the regurgitation of blood from the left ventricle into the left atrium.

3. Post-Procedure

After the transcatheter mitral valve repair procedure, patients typically undergo monitoring to assess their recovery and the effectiveness of the intervention. Post-procedure care may include observation for any complications, management of pain, and monitoring of vital signs. Patients may also require follow-up imaging studies to evaluate the position and function of the implanted device. The expected recovery period can vary, but many patients experience an improvement in symptoms related to mitral valve regurgitation, leading to enhanced quality of life. Additional considerations may include medication management and lifestyle modifications to support heart health.