Friday, March 25, 2011


There are many of us who are charmed by Liz Taylor's beauty, not least, Richard Burton. She is a good actress, and obviously beautiful. Maybe you too, are one of her fan.
However, in 2004, she was diagnosed with heart failure ( the garden variety ), with a severe regurgitant mitral valve. In 2009, she underwent a percutaneous procedure, to implant a mitraclip device sub-mitral valve, to tighten the elongated and flail chordae tendinae, to reduce her MR. This was done percutaneously, without open heart surgery. She took the procedure well, and survived for another 15 months. She passed away, a few days ago.
The mitraclip device is another attempt by interventionist, to repair the mitral valve without the need for open heart surgery. Developed by Dr Ted Feldman, working with Evalve. Evalve is now bought over by Abbott Vascular ( the maker of the Xience V stent ). After their initial successes, Abbott Vascular has embarked on the REALISM registry and also the EVEREST 2 trial to test the clinical use of the Mitraclip against standard open heart surgery mitral valve repair in 37 sites. The 1 year results was presented by Dr Feldman at ACC 2010, and the 2 year results of EVEREST 2 is scheduled to be presented at ACC 2011, soon. I believe that Liz Taylor is a part of the trial. The 1 year results presented last Spring at ACC showed that the mitraclip performed as well as open heart surgical mitral repair, in terms of symptom relieve and LV function improvement and survival. It is widely believed, in our circles, that the results at 2 years will be just as good, except for Liz Taylor, I presume. I am sure that by now, the Americans will have expunge her mitral valve to study the pathology associate with the mitraclip, 15 months after implantation. This is required by the trial design. The earlier postmortem studies seemed to show that the lip just induces sub-mitral valve fibrosis and so some degree of shortening and tightening of the sub-mitral valvular apparatus. The pathologist seem to suggest that there is no mitral stenosis.
Well, I can only surmise that if EVEREST 2 is correct, the cardiac surgeons have one less surgery to perform, although I must say that the MitraClip cannot be cheap. It will surely be at Liz Taylor's price. God rest her soul.


Karen said...

Our heartfelt condolences to Elizabeth Taylor's family. We feel a connection to her because, my mother had the same mitraclip procedure at the same hospital as Ms. Taylor just weeks after her. She was a 92-year-old physician at the time and dying with severe mitral valve regurgitation. She was not a candidate for open heart surgery and two other hospitals had suggested I take her home and call hospice care. IN the past 15 months, her youngest daughter turned 50, her eldest granddaughter daughter turned 18 completed her first semester in college and her grandson had a bar-mitzvah. All these life events would have been bitter sweet for my family without my mother. Thank-god my mother is with us enjoying life, seeing patients and working out 3x a week at almost 94. If it wasn't for her intreventionist and the mitraclip trials none of this would have been possible and our family would be heartbroken.

Karen said...

PS: Medicare and her supplemental insurance paid for the entire mitraclip procedure.

hmatter said...

Thanks Karen,

I am so glad that mum is doing well. Please ask her to follow the cardiologist advice diligently.
There are issues with this Mitraclip. It is good, but not yet perfect.
Thanks for sharing.

Karen said...

Thank-you for your concern but, in the 15 months my mother has had a mitraclip she has had zero complications/problems with the mitraclip. The intreventionist who performed the procedure has performed more of these procedures than any other doctor in the world. Before the procedure the severity of her mitral valve regurgitation was on a scale of 1-4 was a 4 the most severe, now it's between a 1-2. There is no doubt by our family and doctors that the mitraclip procedure is the ONLY reason my mother survived.