Treatment Options for Mitral Regurgitation (2023)


Depending on the severity of your heart valve disease, your cardiologist may recommend the following:

(Video) Mitral Regurgitation Treatment Options at UCSF Medical Center

  • medication
  • surgical treatment
  • Less invasive non-surgical treatments

To learn more about the different treatment options for mitral regurgitation,Continue reading.

Drugs for mitral regurgitation

Drugs have not been shown to help the mitral valves close properly. However, your doctor may recommend medications to relieve symptomsMitral insufficiency.

When you are diagnosedMild (Grade 1) or moderate (Grade 2) mitral regurgitationYour doctor may decide that the best treatment approach is to monitor your condition and prescribe medication to treat your symptoms. These medications may include:

  • Diuretics:Medicines that help reduce fluid retention in your body by increasing the amount of fluid you lose with urination.
  • reduce medicationhypertension(Antihypertensive)that can complicate mitral regurgitation. Your doctor may recommend taking one or more of these antihypertensive medications to control your blood pressure:
    • beta blockers, which slow the heart rate and blood production in the heart
    • Vasodilatatone, which serve to widen (widen) blood vessels. Examples are ACE inhibitors and calcium channel blockers.
  • Antibiotics: Bacteria-killing drugs can help prevent or treat heart valve infection (Endocarditis). With leaking heart valves, there is an increased risk of infection during routine tooth cleaning or surgery.

You may also notice increased tiredness or shortness of breath when you are taking medication. In this case you must inform your doctor immediately.

For more information on medications doctors prescribe for heart valve problems, click here.

Surgical treatments for mitral regurgitation

When you are diagnosedmoderate to severe (Grade 3) or severe (Grade 4) mitral regurgitation, your doctor may recommend surgical treatment.

(Video) New Treatment Option for Mitral Valve Insufficiency

A measure used to determine whether a surgical approach should be performed is calledEjection fraction. Ejection fraction measures the fraction of blood that ejects the lower left ventricle (Left Ventricle) is able to pump the body during one heartbeat.

Surgery to treat the mitral valve is recommended when the ejection fraction falls below 65 percent or when the left ventricle is enlarged (greater than 45 millimeters). Your doctor may recommend surgical treatment of the valve if ultrasound detects a change in the left ventricle, even if you have no symptoms.

Depending on your condition, your doctor may recommend either of these two surgical approaches:

  • Repair of the mitral valve
  • Mitral valve replacement

Heart valve repair is preferable to heart valve replacement when possible. Heart function is usually better if the valve can be repaired, and complications are usually fewer than with valve replacement.

What to expect if you have surgery for mitral regurgitation

Before the operation, you will be given general anesthesia, a drug that puts you in a deep sleep during the procedure. During the surgery, your doctor will make a cut (incision) along the flat bone in the middle of your chest (your chest).sternum) to uncover your heart.

You will be connected to a heart-lung machine, which will take over your breathing and blood circulation during the operation. The surgeon stops your heart, makes an incision to expose the valve, and then repairs or replaces the valve.

Repair of the mitral valve

During mitral valve reconstruction, several techniques can be used alone or in combination to repair the mitral valve:

(Video) Treating Mitral Regurgitation with MitraClip Therapy | Marcie Calfon Press, MD | UCLAMDChat

  • Sail resection, where the surgeon "reshapes" the leaflets by removing some of the leaflet tissue and reattaching the leaflets with sutures
  • Anuloplastic, in which the surgeon implants a ring (a chain-like structure) around the opening of the mitral valve to make it smaller
  • it should, a procedure in which the surgeon joins parts of the valve leaflets together
  • string transposition, in which the surgeon repositions and replaces the fibers (Tendon chords), which connect the muscles of the left ventricle to the leaflets of the mitral valve

New surgical techniques use smaller incisions and robotic surgical techniques to perform this procedure.

Mitral valve replacement

If your valve cannot be repaired and needs to be replaced, your surgeon will implant an artificial (prosthetic) valve. An artificial valve can be mechanical or tissue.

mechanical valves

Mechanical valves are devices made from metallic materials such as titanium. They offer lifetime durability and rarely need to be replaced. The main risk of mechanical valves is the formation of blood clots (Thromboembolie). To prevent blood clots after a mechanical valve is put in, you'll need to take blood thinners for the rest of your life.

A secondary risk is associated with the use of anticoagulant medications. Blood thinners increase the risk of bleeding. If the anticoagulant drugs make the blood too "thin," even small cuts can cause excessive bleeding. If the blood is too "thick," clots can form in the valve, which can rupture and lodge in the blood vessels that lead to the heart or brain, increasing the risk of heart failure.Heart attackÖattack.

Careful monitoring is essential to ensure the right amount of anticoagulant medication. It may require a monthly visit to the doctor's office. New home monitoring devices could allow you to regulate your blood-thinning medication without having to go to the doctor's office.

tissue flaps

Tissue valves are made from valve tissue removed from a cow (bovine), Pork meat (piggy) the human corpse (homoinjerto). Because tissue valves don't promote blood clots, patients who receive them don't have to take long-term anticoagulant medications.

Historically, however, tissue valves have not been as durable as mechanical valves. A tissue flap (also calledBioprothese) can wear out over a period of 10 to 15 years or more. If there is significant deterioration, the valve must be replaced. Replacement, of course, requires repeated surgery. Due to durability issues, tissue valves are mostly implanted in elderly patients. However, they have been continuously improved and are being used more and more frequently.

(Video) MitraClip: Mitral Regurgitation Percutaneous Treatment Option

Risks of heart valve surgery

As with any medical procedure or surgery, there are risks associated with heart valve surgery. As always, it's important to talk to your medical team about your treatment options and the benefits and risks associated with each option. The main risks associated with heart valve surgery include:

  • Tod.The risk of all-cause mortality (risk of death) for heart valve surgery is less than 5%. (That means 5 out of 100 patients will die.)
  • Irregular heartbeat (arrhythmia).Arrhythmias can make you tired or short of breath and put you at risk for blood clots. It may be necessary to take medicines that reduce blood clotting (anticoagulant) to reduce the risk of blood clots, which can form in the heart due to an irregular heartbeat.
  • Infection.After valve surgery, you may be prone to infection or inflammation of the heart valves (Endocarditis). Endocarditis occurs when bacteria enter the bloodstream and infect damaged valve leaflets. People with abnormal or damaged heart valves, or who have had a heart valve replacement, are more susceptible to infections.
  • Risks associated with euthanasiawith general anesthesia
  • scratch,such as bleeding associated with surgery.

Recovery after valve surgery

After valve surgery, recovery in the hospital can take 4 to 10 days, depending on the condition. You can spend the first few days after surgery in an intensive care unit (ICU), where your heart will be closely monitored.

While you're in the ICU, you may have a number of tubes in your body to aid in recovery. These tubes can be used to help you breathe, to drain fluid from your stomach when you are not eating, to drain fluid from your chest, to empty your bladder, and to measure your blood pressure. These tubes are removed when you are transferred from the ICU to another care facility.

You will receive therapy to prevent complications such as pneumonia, collapsed lungs or infection. A nurse or therapist can guide you through deep breathing and coughing exercises and encourage you to move your legs to reduce the risk of blood clots. Your therapy may also include gentle patting on the back to help loosen the fluids in your lungs.

Physical therapy will also be part of the recovery process. At the hospital, you'll be encouraged to walk and learn how to move your arms without injuring your sternum. You will also learn how to carry out everyday activities in a way that does not interfere with the healing process.

Non-surgical and less invasive treatments for mitral regurgitation

Great advances are being made in treatments that do not require open-heart surgery. These approaches use a small, flexible tube (catheter) that is passed through the arteries in the thigh to the heart.

(Video) Mitral Valve Disease: Future Treatment Options | UPMC On Topic

In one approach, a mechanical clip (similar to a small clothespin) is passed through the catheter and into the mitral valve. The clamp clamps the edges of the valve leaflets together to improve their ability to prevent blood from leaking into the upper left ventricle. This device, called the MitraClip, is now an option for people who need to improve mitral valve leakage.To find out how the MitraClip works, click here.In another approach, still under development, doctors are exploring ways to insert a spring-like device through arteries that can change the shape and size of the ring of tissue that surrounds the opening of the mitral valve (Ring). Changing the ring size and shape is intended to help the valve leaflets close properly.

Learn more

If you have heart valve disease, it's important to understand your condition so you can work closely with your medical team to develop a long-term plan for your treatment. We invite you to check them outSecondsCount Heart Valve Center aqui.In this center you will find information aboutadditional resourcesfall back on, as well as tools to help youTrack your meds.


1. Mitral Valve Repair at Dartmouth-Hitchcock
(Dartmouth Health)
2. Mitral Valve/Robotic Heart Valve Surgery
(NewYork-Presbyterian Hospital)
3. Four Basic Treatment Options for Heart Valve Patients
(American Heart Association)
4. Treatment for mitral regurgitation at Northwestern Medicine
(Northwestern Medicine)
5. Asymptomatic Mitral Valve Regurgitation: Risks & Treatment with Dr. James Thomas
6. New treatment for severe mitral regurgitation by cardiologist Lee MacDonald MD, MitraClip
(South Denver Cardiology Associates, P.C.)
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