Mitral valve disease can be caused by a number of factors and each person's valve may be affected differently. Some valve disease may be due to infection, rheumatic fever, heart attack, coronary artery disease or other causes. Common mitral valve diseases include:
- Mitral valve prolapse (MVP) — The mitral valve allows blood to flow from your heart’s left atrium to the left ventricle. With MVP, one or both of the mitral valve’s “flaps,” called leaflets, are enlarged. They bulge back into the atrium each time the heart pumps, causing a small amount of blood to flow back into the atrium. In severe cases, the left side of the heart can becomes enlarged and may require treatment.
- Mitral valve regurgitation — During mitral regurgitation the mitral valve’s two leaflets don’t close properly, causing blood to flow backward into the left atrium. This causes the left ventricle of the heart to work harder. This additional strain can cause further heart complications, and lead to congestive heart failure.
- Mitral valve stenosis — The mitral valve narrows and makes it difficult for blood to flow into the left ventricle. This increases pressure in the left atrium, leading to several problems including pulmonary edema, arrhythmia and blood clots.
Our program has the unmatched expertise to treat all types of valve disease. In fact, we often treat patients with conditions too complicated for other facilities. If it’s appropriate for you, our first choice is always a minimally invasive approach, which leaves the sternum intact. That’s our standard of care.
If your valvular disease is less severe, we may prescribe medications such as diuretics and blood thinners to reduce blood pressure, remove excess fluid from the blood and lessen your heart’s work. We use evidence-based, long-term monitoring to watch your condition for any changes.
Transcatheter Mitral Valve Repair (TMVr) With MitraClip®
This alternative is a less invasive treatment option for certain patients with mitral regurgitation who are at high risk or inoperable for open heart surgery. During a TMVr, the MitraClip device is guided within a catheter up a vein in the patients leg to the heart. The MitraClip device, which is smaller than the size of a dime, is then positioned to join or clip together a portion of the leaking mitral valve leaflets, helping to restore normal blood flow through the patient’s heart.
Valve-in-Valve (VIV) and Valve-in-Ring (VIR) Mitral Valve Replacement
Over time mitral bioprosthestic valves or annuloplasty rings can fail or become dysfunctional. For these patients, our team provides transcatheter valve-in-valve or valve-in-ring replacements (TMVR). These less invasive, catheter-based options are available for patients who are at high risk for a second open surgery. During the procedure, a new transcatheter mitral valve is inserted inside the existing prosthetic valve or annuloplasty ring. These procedures, like other minimally invasive procedures, can be performed without a surgical incision and while the patient's heart is still beating, eliminating the need for the heart-lung machine. Patients often go home one to two days after the procedure.
This transcatheter procedure is completed by using a balloon to open or widen the problem valve to help restore normal blood flow in patients. During the procedure, the physician inserts a balloon via a catheter up through a vein in the patient’s leg to the problem valve in the patient’s heart. Once in place, the balloon is inflated to open or widen the valve and restore normal blood flow. A valvuloplasty can be used for mitral valve stenosis, as well as narrowed tricuspid or pulmonary valves.
Traditional (Open) Valve Surgery
Underlying medical conditions, multiple heart problems and other factors may mean you will do better with a traditional, open procedure for mitral valve repair or replacement. Our team of physicians will work with you to determine the best treatment approach for your particular condition.