Mitral Valve Disorders -- What Are They? Can They Be Treated?
The mitral valve acts as a gate between the left atrium and left ventricle, the two chambers of the heart through which oxygenated blood from the lungs is pumped to the rest of the body. The valve has two moveable flaps that close to prevent blood from leaking from the ventricle back to the atrium or even into the lungs.
If the flaps do not fully close, the condition is known as mitral valve prolapse. "About 2½ percent of the population has mitral valve prolapse," says Farzad Najam, MD, cardiothoracic surgeon. "About 10 to 15 percent of those people will develop the more serious condition, mitral valve regurgitation, which requires surgery," he says.
Regurgitation develops if, when the valve doesn't close all the way, a small amount of blood leaks backward into the upper-left chamber.
Risk Factors and Symptoms
Women are at greater risk for mitral valve prolapse, while men tend to be at increased risk for mitral valve regurgitation.
Conditions that can lead to mitral valve defects include:
- Atherosclerosis (hardening of the arteries)
- High blood pressure
- Heart valve infection
- Cardiac tumors
- Rheumatic heart disease
Symptoms of mitral valve defects include:
- Shortness of breath
- Fatigue
- Exercise intolerance
- Heart arrhythmia
- Chest pain or discomfort
- A sense of a racing heart
- Dizziness
- Fainting
- Anxiety or panic attacks
Surgical Options
Patients who need surgery have two options: a mitral valve repair or a mitral valve replacement."The advantage of having the repair is that we use the patient's own tissue to reconstruct the mitral valve and restore normal function," says Javanshir Janani, MD, cardiothoracic and vascular surgeon. "The repair usually alleviates the patient's symptoms and need for blood thinning medication," he says.
When a replacement is necessary, surgeons remove the mitral valve and replace it with either a mechanical valve or one made with tissue from a pig or cow. The choice of replacement is up to the patient.
Choice of Procedures
There are two options for mitral valve repair or replacement:- Traditional open surgery. The breastbone (sternum) is opened. Patients typically spend five to seven days in the hospital.
- Minimally invasive surgery. This is an option for patients who do not have coronary heart disease. The procedure, called a ministernotomy, requires a smaller opening of the breastbone. Patients typically spend three to six days in the hospital.
