New heart valve treatment coming to Cleveland Clinic

Dr. Mark Malias [Photo: Kaila Jones]

Another new heart valve procedure will be available soon in Vero Beach.

Just three years ago, Vero Drs. Mark Malias and Cary Stowe were among the first cardio-thoracic surgeons in Florida to perform the now widely used trans-aortic valve replacement (TAVR) procedure.

Now Malias and the Welsh Heart Center team are aiming to add another new procedure to their collective resumes: one to treat problems with the heart’s mitral valve.

It is true, according Heart.org, that problems with the aortic valve are far more common than those of the mitral valve. It says only 2 percent of the world’s population suffers from mitral valve problems – but that’s still more than 156 million people worldwide, and until quite recently there were no proven ways to treat the condition known as “mitral valve regurgitation.”

Mitral valve regurgitation occurs when the flaps of mitral valve bulge or “prolapse” into the heart’s left upper chamber, the atrium. This can cause blood inside the heart to leak backwards.

“Symptoms of mitral valve prolapse can vary widely from one person to another,” according to the Mayo Clinic. Those symptoms can include “irregular heartbeat (arrhythmia), dizziness or lightheadedness, difficulty breathing or shortness of breath, often during physical activity or even when lying flat.”

General fatigue makes Mayo’s list as well, so it’s a difficult diagnosis to make.

When it comes to treatment, Malias is clearly energized by a new device that has garnered FDA approval for treating mitral valve prolapse: the MitraClip from Abbott Labs.

“Lots of mitral repairs or mitral replacement options are still in the R&D phase,” Malias says, “but there’s a whole host of them primed and getting ready to come on the market.

“Some are in FDA-regulated trials. Others are past some of the trials and getting ready to be released, and we’ve already embarked on a MitraClip program [in the Cleveland Clinic Florida system].

“The MitraClip,” Malias explains, “is a product from Abbott where they pinch two leaflet portions of the valve together and hold them together to minimize or lessen the amount of regurgitation across that valve. It’s a great option for patients.

“As a surgeon, I’d prefer a surgical repair when we can, but there is a subset of patients with functional mitral regurgitation [for whom] surgical repair doesn’t have the same benefits.”

The MitraClip is currently in use at Cleveland Clinic’s Weston hospital and Malias is hoping to launch it Vero Beach in the near future.

“I think one of the big advantages for the community that we didn’t have before the Cleveland Clinic merger or buyout or however you want to phrase it, is the networking opportunities we are experiencing with other Cleveland Clinic facilities,” he says.

“Whether it’s Martin or Weston, we meet on a weekly basis to discuss difficult cases. I know it’s not sexy like a new [surgical] robot, but that daily or weekly interaction about difficult cases is very helpful.”

In fact, Malias adds, “we’re having a meeting on Wednesday night with all the cardiac teams. Not just the surgeons, but the diagnostic cardiologists and interventional cardiologists, on a Zoom or Go-To-Meeting format to discuss cases and talk about how to kick off MitraClip up here.

“They’re not doing MitraClip in Martin, but they do it down in Weston, so it’s this collaboration along the [Cleveland Clinic] network that is going to be a big benefit for the patients of this community.”

Malias concludes by adding: “It is exciting because there are resources at other places that our patients would benefit from and there’s resources there that can help us bring that technology and new things here” to Vero Beach.

If you think you may have a mitral valve problem, consult your primary care physician. He or she will likely direct you to a specialist to confirm or refute a mitral valve prolapse diagnosis.

Dr. Mark Malias is a cardio-thoracic surgeon with the Cleveland Clinic Indian River Hospital and the Welsh Heart Center. His office is at 3450 11th Court, Suite 105. The phone number is 772-563-4580.

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