TMH Cardiologists Lead Development of Groundbreaking Mitral Valve Procedure
Cardiologists at Tallahassee Memorial HealthCare (TMH) have participated in trials demonstrating promising outcomes with a novel approach for treating patients with functional mitral regurgitation, a condition with few therapeutic options.
Functional mitral valve regurgitation occurs when a defect in the mitral valve allows blood to flow back into the left atrium as the heart contracts. This leads to volume overload, which negatively affects quality of life and can result in hospitalization and early mortality. Unfortunately, these patients often remain symptomatic despite medical intervention and have limited treatment options.
“These patients do not have a viable surgical option, as surgery is not effective for individuals with functional mitral regurgitation or regurgitation caused by changes in the geometry of the left ventricle,” said Thomas E. Noel, MD, an interventional cardiologist with TMH Physician Partners, Services by Southern Medical Group.
Mitral valve edge-to-edge repair is a minimally invasive procedure that treats functional mitral regurgitation by connecting the two leaflets of the mitral valve (mitral valve leaflet approximation), reducing the backflow of blood. This procedure represents a new treatment option for this patient population and is currently being performed at TMH.
The COAPT trial evaluated the safety and efficacy of transcatheter mitral valve leaflet approximation for patients with heart failure and functional mitral valve regurgitation.3 Initially designed to assess the impact of treatment on hospitalizations, the trial’s 24-month results showed that patients treated with edge-to-edge repair experienced lower rates of hospitalization and mortality than those receiving medical therapy alone. Data from five-year outcomes, released in 2023, confirmed these benefits.
“There was still a significant reduction in all heart failure hospitalizations through five years,” Dr. Noel said. “At five years, 33.1% of patients who received the edge-to-edge repair were hospitalized compared with 57.2% of those treated with medical therapy alone.”
At the five-year follow-up, all-cause mortality was 57.3% in the intervention group compared with 67.2% in the control group. According to Dr. Noel, patients at TMH are experiencing similar positive outcomes.
“We participated in the COAPT trial here in Tallahassee,” Dr. Noel said. “We’ve observed these excellent results in our patients. This procedure is well tolerated and very stable.”
The procedure is guided by a transesophageal echocardiogram and fluoroscopy, supported by a team of expert imaging specialists.
“Our imaging team, led by Dr. [Ernesto] Umana and Dr. [Gregory R.] Hartlage, along with lead technologist, Lori Yanisky, provides high-quality imaging,” Dr. Noel said. “Their dedication to perfect imaging makes the procedure more efficient, timely and effective.”
Patients often travel significant distances to receive mitral valve edge-to-edge repair at TMH, and the care team works to streamline the process.
“We get referrals from as far as 100 miles away,” Dr. Noel said. “When patients come from afar, we try to accommodate them by completing pre-procedural testing on the same day and coordinating visits with surgeons and interventional cardiologists on the same visit.”
TMH facilitates easy collaboration with referring physicians, enabling digital sharing of relevant testing and medical records for review before patient treatment. Dr. Noel emphasized the versatility of TMH’s Structural Heart Division in addressing mitral valve disease.
“For functional mitral valve regurgitation, we offer edge-to-edge repair, bioprosthetic valves for patients with previous mitral valve procedures, and a surgical arm for advanced care,” Dr. Noel said. “Programs like ours, with high volumes of these procedures, deliver superior outcomes. We have the highest regional volume of mitral edge-to-edge repairs.
“TMH and Southern Medical Group have invested significantly in recruiting renowned specialists trained to perform these procedures and deliver cutting-edge technology,” Dr. Noel added.
References
- Sannino A, Smith RL II, Schiattarella GG. JAMA Cardiol. 2017;2(10):1130-1139.
- Goliasch G, Bartko PE, Pavo N, et al. Eur Heart J. 2018;39(1):39-46.
- Stone GW, Lindenfeld J, Abraham WT, et al. N Engl J Med. 2018;379(24):2307-2318.
- Stone GW, Abraham WT, Lindenfeld J, et al. N Engl J Med. 2023;388(22):2037-2048.
Research and Clinical Trials
Our heart and vascular team has been conducting research at TMH for more than 20 years, participating in over 150 trials.
Information on these studies can be found on our clinical trials page. To refer or inquire about our heart and vascular trials, contact our partners at the Tallahassee Research Institute, Inc. at 850-431-5024.
Our Locations
Heart Care +2 more
TMH Physician Partners - Cardiothoracic Surgery
1405 Centerville Road Suite 5000, Dogwood Building - Tallahassee, FL 32308
Heart Care +1 more
TMH Physician Partners, Services by Southern Medical Group – Cardiology
1002 N. Arnold Road Suite 301 - Panama City Beach, FL 32413
