Heart Valve Plug
Stopping the Leak: The MitraPlug Customized Heart Valve Plug
Heart valve disorders rank second in all cardiovascular diseases that lead to death.
When valves do not function well, whether by leaking or not opening widely enough, patients often need surgery to repair or replace the valve. Replacement with mechanical valves requires lifelong anticoagulation therapy, and replacement with bio-prosthetic heart valves, made of human or animal tissue, are durable up to a decade, after which the valve needs to be surgically replaced.
Valve repair, then, is becoming more popular, especially in the mitral position, with about 250,000 procedures performed each year in the U.S. and Western Europe. However, about 64% of these patients still experience leakage (also called regurgitation) after the surgery, often because of the inflexibility of the valve repair device.
Emory researcher Muralidhar Padala, PhD, assistant professor in the Division of Cardiothoracic Surgery has invented an adjustable valve repair device that conforms to a patient's needs. The MitraPlug, a transcatheter mitral valve repair technology, mounts directly on the valve cusps and eliminates the leakage through the valve. This novel catheter-plug system requires only a two-inch incision between the ribs, as it is inserted straight into the heart via the ventricular apex when the heart is beating. Using real-time color Doppler guidance, the cardiologist can ensure correction of the leakage by adjusting the position and size of the inflatable plug while the heart is beating. The catheter is then retracted and the incision is closed. This eliminates the need for open-heart surgery, and the patient can go home within 48 hours and with just a small scar.
"Adjustability is the key for successful repair of the mitral valve using transcatheter techniques," says Dr. Padala. "When the valve is repaired using traditional surgery, the surgeon can see and feel the valve, assess the leak and then tailor his technique to best suit the valve. Such freedom is lost when you are working through a small hole in the chest using catheters and get one-shot at implanting the device. MitraPlug regains that freedom by making the implanted device adjustable, so that after implantation the physician can adjust the device as necessary."
Dr. Padala has received much recognition from his peers for his research, including the 2011 Leducq Foundation's Career Development Award, which allows promising young investigators to engage in international research in one of the Foundation's Transatlantic Networks of Excellence. He is representing Emory as a member of the "Mitral Valve Disease: From Genetic Mechanisms to Improved Repair" network, an international consortium of leading scientists studying the pathogenesis of various mitral valve lesions. And in 2012, Dr. Padala, who has his PhD in Bioengineering from the Emory/Georgia Tech Wallace H. Coulter Department of Biomedical Engineering, was selected to receive the Emory Office of Technology Transfer’s Innovation of the Year Award for his percutaneous mitral valve repair system.
"Dr. Padala is a very talented engineer who truly understands the unmet needs in the field of heart valve surgical repair and replacement," says Cale Lennon, director of licensing for Emory's Office of Technology Transfer. "This device provides an elegant solution to correct mitral valve leakage in a discreet patient population for which an effective solution currently does not exist."