Mitral Valve Regurgitation
The mitral valve sits between the top and bottom chamber of the heart on the left side. It allows blood to flow from the left atrium into the left ventricle. It acts as a gate and should only allow blood to flow forward. Sometimes the blood flows back in to the left atrium because the valve doesn’t work properly. This backwards flow of blood is called mitral regurgitation. The most common way to fix the leaky valve is by repairing the valve or replacing it through open heart surgery. There are some patients who are not surgical candidates because of their age, prior history of open heart surgery, lung problems and being too weak or frail for surgery. Those patients may be candidates for percutaneous mitral valve repair or mitraclip.
Symptoms of Mitral Regurgitation
Patients can become short of breath at rest and with exercise, develop swelling in their legs and ankles and have trouble doing their normal activities when they have mitral valve regurgitation. These symptoms are called heart failure. Most of the time the symptoms improve with the use of medication, like blood pressure medications and diuretics or water pills. However, some patients remain symptomatic and the only way to help their symptoms is to do surgery.
Mitral Regurgitation Diagnosis
Mitral regurgitation is diagnosed using an echocardiogram or a transesophageal echocardiogram (TEE). Your health care provider may have heard a murmur when listening to your heart and referred you for an echo. The echo is an ultrasound that allows us to look at the heart muscle, the valves of the heart and how blood flows through the heart. While you are lying down on a bed, we slide an ultrasound probe (special camera) across your chest with the help of clear gel. The cardiologist will look over the pictures and based on the pressures and flow of blood through the heart can diagnose mitral regurgitation.
A TEE is a special kind of echocardiogram that uses a probe that goes down the throat to get pictures of the back side of the heart and valves. The cardiologist is able to measure pressures and see the amount of back flow or regurgitation across the mitral valve. You are given anesthetic or medicine to go to sleep so you are not awake or aware of the tube in your throat.
Mitral Regurgitation Treatment
Mitral valve repair or replacement is the preferred ways of treating mitral regurgitation. This requires open heart surgery by a cardiothoracic surgeon and either a ring is place around the valve to keep it from leaking or the valve is replaced with an artificial valve.
Mitraclip is indicated for patients who have degenerative mitral valve disease (the valve itself doesn’t work) and who are not candidates for open heart surgery (prohibitive risk). Transcatheter or percutaneous mitral valve repair using the mitraclip is a minimally invasive procedure that is done with catheters or small tubes that are guided through the vein from the leg to the heart. A clip is placed on the leaky part of the mitral valve to prevent the valve from letting the blood flow backwards. It creates a figure 8 opening of the mitral valve. The hospital stay is shorter and recovery time is quicker compared to surgical valve repair or replacement.
CHI Health Heart & Vascular Care is the first hospital in the region to provide this treatment. Read more about the Mitraclip procedure.