At Institut Jantung Negara (IJN), Malaysia’s largest heart hospital, thousands of patients seek care for complex conditions each year. In the realm of cardiac care, cutting-edge innovations continue to redefine treatment approaches for heart conditions – and IJN stands at the forefront.

While cardiac attacks often dominate public perception of heart diseases, other complications can also severely affect quality of life, and even become life-threatening. Among these is mitral valve regurgitation.

FMT Lifestyle spoke with senior consultant cardiologist Dr Amin Ariff Nuruddin to learn about this condition and its treatment.

MitraClip

“Our heart has four valves – two on the left and two on the right. In simple terms, a valve is like a door; it opens and closes. The function of these valves is to transport blood from the lungs to the heart, the body, and back to the lungs,” he explained.

“Over time, or due to disease, some valves can start to leak. In medical terms, this is called regurgitation.”

The mitral valve, located on the left side of the heart, controls blood flow from the left atrium to the left ventricle. With mitral regurgitation, the valve does not close properly, causing blood to flow backward into the atrium instead of moving forward to the rest of the body.

What does that cause? “Patients will get out of breath. With the leakage increasing, they get very breathless, they might not be able to do the things that they normally do.”

In the past, treatment typically involved medication, with surgery being a first choice whenever possible. However, Amin highlighted that, given Malaysia’s ageing population and prevalence of comorbidities, open-heart surgery carries significant risks.

For many, this means relying on medication – and an impaired quality of life. Enter the MitraClip, a minimally invasive solution that places a small device on the mitral valve to stop the leakage.

The procedure involves inserting the device via a catheter through the groin, guided by a transesophageal echocardiogram. Once in place, the MitraClip grasps and secures the valve leaflets, effectively reducing regurgitation.

“This has benefited many patients worldwide. It is a standard treatment globally and one of the mainstays of therapy for these patients,” Amin said.

IJN has performed over 100 MitraClip procedures with remarkable success, including on two patients in their 90s who now enjoy improved quality of life.

Aortic procedures

Heart diseases extend beyond valves, with the aorta also susceptible to damage.

“The aorta is the biggest blood vessel that comes out of the heart and runs throughout the body, supplying all the organs with blood,” senior consultant cardiothoracic surgeon Dr Paneer Selvam Krishna Moorthy explained.

Three major issues affecting the aorta include aortic dissection (a tear in the inner layer of the aorta); aortic aneurysm (a bulge in the aortic wall); and congenital defects, where the aorta develops abnormally during pregnancy. This means aortic diseases can affect people of all ages.

“Dissection is a life-threatening situation requiring immediate medical attention, often surgery,” Paneer noted. Treatment involves removing the damaged section of the aorta and replacing it with an artificial tube.

Patients at IJN have two options: the On-X Ascending Aortic Prosthesis (On-X AAP), a mechanical valve made of carbon and metal, and the Konect Tissue Valve, a bioprosthetic made from cow tissue.

Mechanical valves are durable but require lifelong anticoagulation medication. Tissue valves, while avoiding this need, have a shorter lifespan.

“Younger patients below age 50 are usually given mechanical valves, while tissue valves are more suited for older patients,” Paneer explained.

Both options at IJN offer reduced dependence on medication and longer-lasting results compared to other products on the market.

“This surgery has become very safe, almost equivalent to a simple bypass. Our outcomes are on par with the top centres in the US or UK,” he added.

With such advanced procedures, IJN continues to set benchmarks in cardiac care. For Malaysians grappling with heart conditions, these breakthroughs represent not just medical progress but also the promise of brighter futures.