Repairing Guides

how to repair mitral valve regurgitation

by Dr. Beatrice Waelchi PhD Published 3 years ago Updated 2 years ago
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To treat mitral valve regurgitation, your surgeon might shape, rebuild, or trim the flaps that open and close the valve or fix the chords that attach them to the heart. The surgeon might also sew a ring of cloth, tissue or metal around the valve to tighten it and stop blood from leaking backwards.Jun 3, 2022

Medication

It is seen that once a successful surgery of mitral valve repair is done, a patient may live without complications for at least 10 years. With recent scientific advancement and with proper after surgery care procedures, the patients are seen to lead a complication free life even after 20 years.

Procedures

  • Age
  • Sex
  • Hypertension
  • Dyslipidemia
  • Duration of diabetes
  • eGFR
  • Ejection fraction
  • Presence of mitral valve disease
  • Presence of aortic-valve sclerosis

Nutrition

  • Curb smoking and alcohol intake
  • Maintain an optimal weight and BMI
  • Eat a well balanced diet
  • Those at high risk should consume a salt-restricted and fat-free diet.
  • Follow a suitable exercise program. High-intensity exercises are to be avoided for patients with leaky valve

How long can you Live after mitral valve repair?

Mitral valve surgery is not dangerous in every case. It may carry certain risks that may harm your health and needs to be sorted out soon. If this surgery leads to formation of blood clots that may block heart or brain blood vessels, then it may lead to heart attack or stroke and then cardiac or brain failure resulting in death.

What is life expectancy after mitral valve repair?

When and how to treat a leaky mitral valve?

How dangerous is mitral valve replacement surgery?

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When should a mitral valve be repaired?

Mitral valve repair surgery is recommended if you have severe mitral valve regurgitation symptoms. Mitral valve stenosis. The valve leaflets become thick or stiff, and they may fuse together. This causes the valve to become narrowed and reduces blood flow through the area.

Can mitral valve regurgitation be cured?

Severe mitral valve regurgitation often requires a catheter procedure or heart surgery to repair or replace the mitral valve. Without proper treatment, severe mitral valve regurgitation can cause heart rhythm problems (arrhythmias) or heart failure.

Can the mitral valve be fixed without surgery?

The Structural Heart and Valve Center at NYP/Columbia has long been a leader in catheter-based treatment—the least invasive therapy—to repair the mitral valve. This valve regulates blood flow between the upper and the lower chambers on the left side of the heart.

How serious is mitral valve surgery?

As with any surgical procedure, mitral valve surgery has risks. The most serious complications associated with mitral valve surgery include stroke, placement of a pacemaker, kidney failure, lung failure, and wound infection. Fortunately, these are unusual.

What should I avoid if I have mitral valve regurgitation?

Eating well: You need to eat lots of fruits, vegetables, whole grains, and proteins. You'll need to limit salt, added sugars, saturated and trans fats, and alcohol.

How long can I live with mitral valve regurgitation?

People with mild mitral valve regurgitation often live long, full lives and never require treatment. But once the condition becomes severe and begins to affect your heart's ability to pump blood, you may need surgery to prevent serious complications such as congestive heart failure or even death.

Does mitral valve regurgitation shorten your life?

Patients with residual or recurrent regurgitation have reduced event-free long-term survival and many will require reoperation.

What is the average age for heart valve replacement?

Fact: Valve Replacement and Heart Bypass surgery (or a combination of the two) are the most common procedures in the “elderly.” Fact: More than 30% of the patients having heart valve surgery are over 70. Fact: More than 20% of heart valve surgical patients are over 75 years of age.

Is it better to have a mitral valve repaired or replaced?

Whenever possible, it's better to repair the mitral valve rather than replace it.” Mitral valve repair may help you to avoid complications that can occur with mitral valve replacement, including the risk of blood clots with mechanical valves.

Can I live a normal life after mitral valve repair?

Overall 1‐ and 5‐year survival was 90.7%, 74.2% versus 81.3%, 61.0% (P<0.01). Median survival after MV ‐repair was 7.8 years, close to 8.5 years (95% CI : 8.2–9.4) in the age‐matched UK population (ratio 0.9). Rate of re‐operation for MV ‐dysfunction was 2.3% versus 2.5% (mitral valve replacement, P=1.0).

What is the success rate of mitral valve replacement surgery?

With proper patient selection and timely intervention, the estimated success rate of mitral valve repair surgery is around 95%. Almost 95% of patients are free of reoperation for 10 years. At 20 years, around 90% of people do not need reoperation for mitral valve repair.

How long does it take to fully recover from mitral valve repair surgery?

What is the recovery like for mitral valve repair? Recovery from valve repair surgery usually takes four to eight weeks. Some people may need longer.

Does mitral valve regurgitation get worse with age?

Mitral regurgitation becomes more common with age. This is because of age-related wear and tear of the valve. In the population as a whole around 2% of people have at least moderate mitral regurgitation.

Should I worry about mitral regurgitation?

Acute, severe mitral valve regurgitation is a medical emergency. It needs surgery right away. See your healthcare provider for regular check-ups to monitor your condition. If your symptoms get worse or become severe, see your healthcare provider right away.

Can you live a long life with a leaky heart valve?

The chances of survival in an untreated heart valve disease are poor. Aortic stenosis (AS): Patients with severe AS develop symptoms in 3 to 5 years. Around 75% of patients with unoperated aortic stenosis may die 3 years after the onset of symptoms.

How can I strengthen my heart valve naturally?

9 Natural Ways to Strengthen Your Heart ValvesLook at Your Plate. ... Pop Some Fish Oil. ... Keep Your Weight in Check. ... Decrease Salt Intake. ... Get Better Sleep. ... Move Around. ... Try Meditation. ... Up Your Dental Hygiene.More items...•

How do you repair a mitral valve?

In mitral valve surgical repair, a doctor removes the part of the mitral valve that doesn't close properly , as shown in the top image. Then a doctor stitches the valve edges together and tightens the width of the valve with a ring, called an annuloplasty band (bottom image). This image shows a robotic surgery mitral valve procedure.

Why do doctors repair mitral valves?

Mitral valve repair may be done to avoid complications that can occur with mitral valve replacement, such as blood clots due to mechanical valves and biological tissue valve failure.

What causes a valve to become narrowed?

Mitral valve stenosis. The valve leaflets become thick or stiff, and they may fuse together. This causes the valve to become narrowed and reduces blood flow through the area.

How long do you stay in the ICU after mitral valve surgery?

If you've had mitral valve repair or replacement surgery, you'll generally spend a day or more in the intensive care unit (ICU). You'll be given fluids and medications through an IV. Other tubes will drain urine from your bladder and fluid and blood from your chest. You may be given oxygen.

Why do my mitral valves bulge?

This commonly occurs due to valve leaflets bulging back — a condition called mitral valve prolapse. In another condition, called mitral valve stenosis, the leaflets become thick or stiff, and they may fuse together. This results in a narrowed valve opening and reduced blood flow through the valve.

Why do doctors preserve cords during heart surgery?

When possible, doctors may preserve the cords supporting the valve during the procedure, in order to preserve as much of the heart's function as possible. In some cases, a catheter procedure may be conducted to insert a replacement valve in a biological tissue valve in the heart that is no longer working properly.

What is open heart surgery?

Open-heart surgery, which involves a cut (incision) in the chest.

When is mitral regurgitation surgery recommended?

When a patient with mitral regurgitation develops symptoms, a decrease in heart function, or an increase in heart size, surgery is nearly always recommended. Surgery should also be considered when a patient develops atrial fibrillation, which is an irregular heartbeat. Surgery is also recommended in most asymptomatic patients who have a severe leak. In asymptomatic patients with severe mitral regurgitation, surgery improves long-term survival. In contrast, waiting for the development of symptoms or changes in heart function can leave patients with permanent heart damage.

What causes mitral regurgitation?

The most common cause of mitral regurgitation is a condition called degenerative mitral valve disease —this is also called mitral valve prolapse, myxomatous mitral valve disease, and a floppy mitral valve. Such valves can be repaired (rather than replaced) in more than 95% of patients. Cleveland Clinic heart surgeons have ...

How long after mitral valve repair can you reoperate?

After mitral valve repair, 95% of patients are free of reoperation at 10 years, and this figure is approximately 90% at 20 years. Thus, reoperation is uncommon after a successful mitral valve repair. An echocardiogram is recommended annually to assess valve function. In addition, patients who had valve surgery must take steps to prevent infection and reduce the risk of endocarditis (an infection of the valve).

What is the procedure for mitral valve repair?

Many patients with mitral valve disease have atrial fibrillation, (an abnormal heart rhythm.) For these patients, at the time of mitral valve repair, Cleveland Clinic surgeons perform an ablation (Maze procedure) with the intent of curing the atrial fibrillation. In some patients with atrial fibrillation, a sternotomy (standard) ...

How to repair mitral valve prolapse?

These Gore-Tex chords generally last forever. A second technique used for correction of anterior leaflet prolapse is chordal transfer, which involves transfer of chords from another part of the valve to the area with abnormal chords. Both techniques provide excellent long-term results for patients.

What is the repair of the posterior leaflet chordae?

Posterior leaflet chordae are transferred to the unsupported free edge of the anterior leaflet. The posterior leaflet is then repaired. A cloth annuloplasty band completes the repair.

How big is the incision for mitral valve repair?

Today, the majority of isolated mitral valve repairs can be performed through a 2-3 inch incision on the right side of the chest. In many cases, we can employ the surgical robot and limit incision size to 1 inch.

How is mitral valve repair done?

It allows us to stop the heart and work on the mitral valve. The valve is then repaired using a number of techniques. Mitral valve repair surgery is very much an art form and experience is key. Techniques include putting in chords in place of the ruptured chords that led to the leaky valve in the first place. Cutting out extra mitral valve leaflet tissues for large prolapsed valves and making other modifications to the valve leaflets to prevent further leakiness . Finally a band is typically placed around the valve known as an annuloplasty ring. This is due to most patients with mitral valve disease having a larger than normal annulus.

How long does it take to repair a mitral valve?

The heart is then restarted, the patient is taken of the heart lung machine and the chest is closed. The whole process may typically take between 2-4 hours depending on how complex the mitral valve repair surgery is.

What are the complications of mitral valve repair?

Complications include lung and kidney issues.

What is the chance of survival of mitral valve repair?

In a non-complicated repair the chance of survival should exceed 99% !

What happens when a mitral valve is damaged?

When the mitral valve is severely diseased it can lead to heart failure and associated symptoms such as shortness of breath and fatigue as well as heart enlargement. The most common diseases are a leaky mitral valveknown as mitral regurgitationand a tight mitral valve known as mitral stenosis. Mitral valve repair is typically reserved for mitral valve regurgitation. When fixing the mitral valve by surgery there are 2 main approaches. The first is replacing the valve in a mitral valve replacement operation, for example using a metal or a tissue valve.

What doctor should I see for a heart attack?

I would suggest seeing the associated cardiologist or cardiac surgeon to ensure nothing is missed.

Can MRI scans be done on mitral valves?

If it was a mitral valve repair, from a technical viewpoint a MRI scan should pose no issue or concern.

When is valve repair recommended?

Repair for mitral valve regurgitation may be recommended based on a few things. These include whether the valve can be repaired successfully.

When is valve replacement recommended?

Examples of serious damage or complicated conditions that might lead to mitral valve replacement include:

Transcatheter repair

A transcatheter procedure is a newer way to repair a mitral valve. It does not require open-heart surgery. It is a minimally invasive procedure. A doctor uses catheters in blood vessels to insert a device in the valve. The device helps keep blood from leaking backward. This may relieve symptoms and improve quality of life.

Why repair mitral valve?

Repairing the mitral valve rather than replacing it with an artificial valve may prevent the need for lifelong use of blood-thinning medications. It also preserves the internal structure of the heart, which may keep patients healthier in the long run. Two different mitral valve repair techniques may be used.

Which technique is used to repair mitral valves?

View of repaired mitral valve using the neochordal technique from the left atrium.

Who Is Eligible for the Procedure?

Not all patients are candidates for the minimally invasive mitral valve repair approach. Some might require another procedure on their heart, such as a coronary artery bypass grafting procedure, and therefore would need to undergo their surgery through a traditional sternotomy approach.

What is the purpose of annuloplasty ring?

After the leaflets are repaired, the surgeon places an annuloplasty ring to restore the original size of the mitral valve and to ensure a lasting result of the repair by recreating the tight seal between the two leaflets.

What is the purpose of a special ring after leaflets are repaired?

After the leaflets are repaired, the surgeon places a special ring (an annuloplasty ring) to restore the original size of the mitral valve and to ensure a lasting result of the repair by recreating the tight seal between the two leaflets.

What is a Mitraclip?

This procedure uses a small clip to repair the heart's mitral valve to treat mitral regurgitation. The clip is inserted through the venous system without any chest incisions.

What is the name of the condition where blood flows backwards into the upper chamber?

This condition, known as mitral valve regurgitation ( or mitral insufficiency), is one of the most common forms of heart valve disease.

How Long Can You Live With Mitral Valve Regurgitation?

I’ve had patients live into their 90s and even 100s with mitral valve regurgitation—it’s the best-tolerated heart valve problem. Unfortunately, it occasionally progresses, becomes symptomatic, and leads to complications such as heart failure that shorten life expectancy.

What happens if you stretch your mitral valve too far?

If it progresses, however, more blood spills backwards through the leaky mitral valve, and the ventricle has to pump harder to meet the body’s demands for oxygenated blood. This places extra strain on the heart and, over time, may cause changes in the heart such as enlargement and weakening of the left ventricle. Think of the analogy of saltwater taffy—if you stretch it too far, it won’t snap back.

What is it called when the mitral valve doesn't close?

Mitral valve regurgitation—also called mitral insufficiency or incompetence —occurs when the valve doesn't close as tightly as it should and some of the blood spills backward into the atrium. This reduces the amount of blood pumped out into the body with each beat.

Where is the mitral valve located?

The mitral valve, one of the four valves separating the chambers of your heart, is located between the left atrium (the top chamber) and the left ventricle (the lower chamber). Oxygenated blood flows from the lungs into the left atrium, and then through the mitral valve into the left ventricle. From the ventricle, blood is pumped out through the aorta and into the rest of the body.

Can mitral valve prolapse cause regurgitation?

In most cases, mitral valve prolapse does not lead to severe regurgitation.

How to control blood pressure?

Control your blood pressure with sodium restriction and other diet changes, stress management, targeted supplements, and medications, if needed.

Can mitral regurgitation cause anemia?

In all my years as a clinical cardiologist, I have not seen mitral regurgitation-related anemia. Diminished cardiac output can lead to renal insufficiency (impaired kidney function) over time, and this could result in a chronic anemia-like situation. It is possible, but very rare.

What is the name of the condition where blood flows the wrong way through a valve in the heart?

Mitral valve regurgitation, when some of your blood flows the wrong way through a valve in your heart, doesn’t have to slow you down. This is especially true if you have a mild case of it. There are lots of ways to help you or a loved one manage the condition and stay as healthy as possible. They include exercise, eating well, support groups, ...

How to manage heart disease?

Your doctor might recommend at least two-and-a-half hours of moderate-intensity aerobic exercise every week and a limit on the amount of sitting you do.

What is a thin tube that is guided from a blood vessel to your heart called?

Cardiac catheterization, in which a thin, flexible tube is guided from a blood vessel to your heart so the doctor can do tests

What happens if your heart isn't working?

If it’s not working right, some blood can flow back into the left atrium. Depending on your case, you could feel very tired, and have chest pain or shortness of breath when this happens. If it’s not treated, some cases can worsen and cause bigger health problems.

Does smoking cause regurgitation?

Smoking: It increases your risk for heart attacks and makes regurgitation worse. If you are a smoker and have trouble stopping, talk to your doctor about ways you can break the habit.

Can regurgitation be stopped?

Medication: No medication can directly stop the regurgitation. But medicine might help with other issues it’s causing, such as high blood pressure. Be sure to follow the instructions and talk with your doctor if you feel side effects. Keep your appointments: You need to make your health a top priority.

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Diagnosis

Treatment

Clinical Trials

Coping and Support

Medically reviewed by
Dr. Kabir Sethi
Your provider will work with you to develop a care plan that may include one or more of these treatment options.
The treatment depends on the severity of the condition. Medications may help reduce the symptoms while surgery to repair or replace the mitral valve may be recommended for severe cases.
Medication

Diuretics: Helps relieve fluid accumulation in lungs and legs which may accompany mitral regurgitation.

Chlorothiazide . Indapamide


Diuretics: Helps relieve fluid accumulation in lungs and legs which may accompany mitral regurgitation.

Chlorothiazide . Indapamide


Angiotensin-converting enzyme (ACE) inhibitors: To manage high blood pressure.

Quinapril . Perindopril erbumine


Beta blockers: To prevent arrhythmias by reducing blood pressure and relaxing smooth muscles of blood vessels.

Atenolol . Bisoprolol


Anticoagulants: To reduce the risks of clot formation.

Warfarin . Heparin

Procedures

Valve repair: To reconnect valve leaflets or removes excess valve tissue.

Valve replacement: The narrowed valves are removed and replaced with a bio prosthetic valve.

Nutrition

Food doesn't directly affect mitral valve regurgitation but eating food that helps maintain general health of the heart is important.

Specialist to consult

Cardiologist
Specializes in the diagnosis and management heart related disorders.
Cardiothoracic surgeon
Specializes in the surgical procedures of the heart, lungs, esophagus, and other organs in the chest.

Preparing For Your Appointment

  • Your doctor will ask about your medical history and your family history of heart disease. Your doctor will also perform a physical exam that includes listening to your heart with a stethoscope. Mitral valve regurgitation usually produces a sound of blood leaking backward through the mitra…
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Overview

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Why It's Done

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Risks

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How You Prepare

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What You Can Expect

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Mitral valve repair and mitral valve replacement are types of surgery to fix or replace a leaky or stiff mitral valve in the heart. The mitral valve is between the left heart chambers (left atrium and left ventricle). Mitral valve repair and mitral valve replacement may be done as an open-heart surgery procedure or as minimally inv…
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Results

  • Surgery or another procedure to repair or replace a mitral valve may be done if you have mitral valve disease such as: 1. Mitral valve regurgitation.The flaps (leaflets) of the mitral valve don't close tightly, causing blood to leak backward. Mitral valve regurgitation is common in people with mitral valve prolapse. Mitral valve repair surgery is r...
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Clinical Trials

  • Possible risks of mitral valve repair and mitral valve replacement surgery include: 1. Bleeding 2. Blood clots 3. Malfunction of the replacement valve 4. Irregular heartbeats (arrhythmias) 5. Infection 6. Stroke 7. Death
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Treatment

  • Before mitral valve repair or replacement, an echocardiogram and other tests may be done to get more details about your heart condition. Your care providers will review what to expect during surgery and discuss any concerns you may have. As you prepare for mitral valve repair or replacement, it can be helpful to talk to your loved ones about your hospital stay and what help y…
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Health

  • Surgery to repair or replace the mitral valve is done at a hospital by a heart (cardiac) surgeon. If you need heart surgery for another condition in addition to mitral valve disease, the surgeon may perform both surgeries at the same time.
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Symptoms

  • Mitral valve repair and replacement surgery may help reduce symptoms and improve quality of life in people with mitral valve disease. If you had mitral valve replacement with a mechanical valve, you'll need blood thinners for life to prevent blood clots. Biological tissue valves break down (degenerate) over time and usually need to be replaced. Regular health checkups are needed to …
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Diagnosis

  • Explore Mayo Clinic studiesof tests and procedures to help prevent, detect, treat or manage conditions.
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Clinical significance

Causes

  • In 2015, patients traveled to Cleveland Clinic from all 50 states and 103 countries for their cardiovascular care.
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Advantages

  • Many patients with mitral valve disease are asymptomatic (have no symptoms), even with a leak that is severe. When symptoms develop, they include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations (extra or skipped heart beats).
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