Expanding Access to Advanced Mitral Valve Care in Erie

The Structural Heart Center at AHN Cardiovascular Institute is helping patients with complex mitral valve disease access expert evaluation and innovative treatment options at AHN Saint Vincent Hospital. As the only hospital in Erie offering MitraClip^TM transcatheter edge-to-edge repair (TEER), eligible patients in the region can benefit from shorter hospital stays, faster recovery, and improved quality of life with this non-operational treatment option for mitral regurgitation.

Delivering leading-edge structural heart care close to home

While mitral regurgitation can be managed with medications and ongoing monitoring for some patients, others may experience ongoing symptoms despite guideline-directed medical therapy. Typical symptoms of mitral regurgitation include:

• Shortness of breath
• Fatigue
• Reduced exercise tolerance
• Recurrent heart failure exacerbations

“Historically, many of these patients have required referral outside the Erie region for advanced structural heart evaluation and treatment,” said Orestis Pappas, MD, an interventional cardiologist at Saint Vincent. “The addition of MitraClip therapy represents a significant milestone in the growth of our structural heart program.”

Minimally invasive option for mitral valve repair

Compared to traditional surgical approaches, MitraClip is a less invasive option that uses catheter-based technology — guided by high-fidelity echocardiographic and fluoroscopic imaging — to repair the mitral valve without the need for a sternotomy or cardiopulmonary bypass. The result is reduced valve leakage, more efficient blood flow through the heart, and relief of symptoms associated with mitral regurgitation.

“One of the most rewarding aspects of MitraClip therapy is seeing how quickly some patients begin to feel the difference,” said Dr. Pappas. “By improving how the mitral valve functions, we're often able to help patients breathe easier, improve their functional status, and spend less time in the hospital.”

Multidisciplinary approach to patient selection

While MitraClip therapy is a promising approach, not every patient with mitral regurgitation is a candidate. Determining candidacy requires comprehensive evaluation of each patient's anatomy, symptoms, comorbidities, and treatment history by a multidisciplinary team.

At Saint Vincent, that team is comprised of Dr. Pappas, cardiothoracic surgeon Thomas Person, MD, cardiac imaging specialists, anesthesiologists, heart failure specialists, and other cardiovascular specialists.

This collaborative approach ensures select patients with mitral regurgitation who are considered high or prohibitive surgical risk will receive the most appropriate intervention — whether that is continued medical management or surgical repair or replacement.

Referral considerations for structural heart evaluation

Early referral to the AHN Structural Heart Center can help identify candidates who may benefit from advanced intervention that can potentially improve long-term outcomes.

Referring providers should consider structural heart evaluation for patients with:

• Symptomatic moderate-to-severe or severe mitral regurgitation
• Persistent symptoms despite guideline-directed medical therapy
• Recurrent heart failure admissions
• Symptoms or functional limitations that appear disproportionate to current medical management

“Providers don't need to wait until patients have exhausted every treatment option before making a referral,” said Dr. Pappas. “Early evaluation gives our team the opportunity to assess disease severity, review treatment options, and determine which therapies may help before further cardiac deterioration occurs.”

How to refer

To learn more or refer a patient to Structural Heart Center at AHN Saint Vincent Hospital, visit Health Care Professionals at Allegheny Health Network.

When submitting a referral, providers are encouraged to include a patient’s recent echocardiogram reports and images, symptom history, relevant comorbidities, and current medications to help facilitate timely evaluation.