Mitral Regurgitation

Mitral Regurgitation

What is mitral regurgitation?

The mitral valve is a heart valve between the left atrium and the left ventricle. Mitral regurgitation is where this valve leaks and allows blood to flow backwards as well as forwards

What causes mitral regurgitation?

Mitral regurgitation is caused by a problem with the valve itself (primary or degenerative mitral regurgitation) or a problem with the heart chamber the mitral valve is anchored to (secondary or functional mitral regurgitation).

Primary mitral regurgitation is usually caused by mitral valve leaflet prolapse, that is where the leaflets do not probably overlap in the middle of the valve when the valve is supposed to be closed. Secondary mitral regurgitation is caused by dilatation (enlargement) of one of the heart chambers that the mitral valve is anchored to. Most commonly, secondary mitral regurgitation is caused by a dilated left ventricle, usually secondary to a heart muscle problem called a cardiomyopathy. It is quite commonly seen in patients who have had a heart attack impact on the heart function.

How is mitral regurgitation assessed?

Patients with mitral regurgitation usually have a murmur which can be detected with a stethoscope. Much more information about the severity and cause of mitral regurgitation can be gained by doing a transthoracic echocardiogram.

Patients with significant mitral regurgitation will generally be offered regular assessment to monitor the severity of mitral regurgitation. When the mitral regurgitation becomes severe and the patient develops symptoms, or the heart function starts to deteriorate, then treatment should be considered.

How is mitral regurgitation treated?

Where the mitral valve disease is mild or moderate, generally it can be managed with medication. When it becomes severe and the patient starts to develop symptoms, then mitral valve repair or replacement should be considered.

For most patients, open heart surgery is the preferred treatment option. Where possible surgery will try to repair the valve as this gives a good generally gives the best longer term result. If the valve is not repairable then mitral valve replacement with either a tissue or mechanical valve can be considered. For patients who are at increased risk for surgery, for example due to the age or because they have other medical problems, and for most patients with secondary mitral regurgitation, then a minimally invasive technique called MitraClip may be recommended.

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