Mitral valve disease treatment depends on your symptoms, the severity of the condition, and if your condition is getting worse.
A doctor trained in heart disease (cardiologist) will provide your care. Treatment may include:
- Monitoring your condition with regular follow-up appointments
- Making healthy lifestyle changes
- Taking medications to treat symptoms
- Taking blood thinners to reduce the risk of blood clots if you have a certain irregular heart rhythm called atrial fibrillation
Surgery or other procedures
Your mitral valve may eventually need to be repaired or replaced. Doctors may suggest mitral valve repair or replacement even if you aren't having symptoms, as this may prevent complications and improve outcomes. If you need surgery for another heart condition, your doctor may repair or replace the diseased mitral valve at the same time.
Mitral valve surgery is usually performed through a cut (incision) in the chest. In some cases, doctors may perform minimally invasive heart surgery, which involves the use of smaller incisions than those used in open-heart surgery.
Doctors at some medical centers may perform robot-assisted heart surgery, a type of minimally invasive heart surgery in which surgeons use robotic arms to conduct the procedure.
Surgery options include:
Mitral valve repair
Mitral valve repair is recommended, when possible, as it preserves your heart valve and may preserve heart function. To repair a mitral valve, surgeons may patch holes in a valve, reconnect valve flaps (leaflets), separate valve leaflets that have fused, replace the cords that support the valve, or remove excess valve tissue so that the leaflets can close tightly. Surgeons may often tighten or reinforce the ring around a valve (annulus) by implanting an artificial ring.
The mitral valve may be repaired using a long, thin tube (catheter) and clips, plugs or other devices.
In one catheter procedure, doctors insert a catheter with a clip attached in an artery in the groin and guide it to the mitral valve. Doctors use the clip to reshape the mitral valve. People who have severe symptoms of mitral valve regurgitation and who aren't candidates for surgery or who have high surgical risk may be considered for this procedure.
In another catheter procedure, doctors may repair a previously replaced mitral valve with a leak around it by inserting a device to plug the leak.
Sometimes, doctors use a balloon-tipped catheter to repair a mitral valve with a narrowed opening. The catheter is gently guided to the location inside the artery. The doctor then inflates the balloon, which expands the opening of the valve. The balloon is then deflated, and the catheter and balloon are removed. You may need additional procedures to treat the narrowed valve over time.
Mitral valve replacement
If your mitral valve can't be repaired, surgeons may replace the valve. In mitral valve replacement, your surgeon removes the damaged valve and replaces it with a mechanical valve or a valve made from cow or pig heart tissue (biological tissue valve).
Biological tissue valves break down over time, and often eventually need to be replaced. A catheter procedure can be used to insert a replacement valve in a biological tissue replacement valve that is no longer working properly.
People with mechanical valves will need to take blood-thinning medications for life to prevent blood clots. Your doctor will discuss with you the benefits and risks of each type of valve and discuss which valve may be appropriate for you.
Potential future treatments
Doctors continue to study catheter procedures to repair or replace mitral valves. Some medical centers may offer mitral valve replacement during a catheter procedure as part of a clinical trial for people with severe mitral valve disease who are aren't candidates for surgery.