mitral regurgitation-1What is mitral regurgitation?

Mitral regurgitation (MR) is the most common form of valve disease. This condition occurs when the mitral valve located between the heart’s left atrium and left ventricle does not close properly. In turn, some blood leaks back into the atrium when the ventricle contracts. Over time, the left atrium enlarges in order to accommodate the additional blood. Likewise, the ventricle also dilates as it attempts to meet its increased blood flow demands. Eventually, serious complications can occur including arrhythmia, pulmonary hypertension, and heart failure.

What are symptoms of mitral regurgitation?

Symptoms depend on severity of the condition but may include:

  • Shortness of breath
  • Abnormal heart murmurs (your doctor may detect this with a stethoscope)
  • Heart flutters or palpitations
  • Fatigue
  • Swollen feet or ankles

How is mitral regurgitation diagnosed?

Mitral valve regurgitation can be diagnosed with a variety of tests including:

  • Echocardiogram.  These are used to provide a visualization of the heart to locate abnormalities in structure or function, in this case, with the mitral valve.
  • Electrocardiogram (ECG). An ECG uses electrodes on the chest to record the electrical activity of your heart. It can determine if your heart is receiving enough oxygen or beating at an abnormal rhythm. 
  • Chest X-ray. This checks for enlargement of the heart ventricles which can be a sign of mitral regurgitation.
  • Cardiac CT or PET scan.  One of these may be performed to determine the cause of MR or the best method of treatment.
  • Cardiac catheterization. This may be required to directly measure pressures in the heart or to rule out blockages in the heart arteries which may lead to worsening heart function or valve function.

How is mitral regurgitation treated?

Mitral regurgitation is treated based on its severity. For some patients, symptoms may be well-managed with medications such as diuretics, although these medicines will not treat the underlying condition. For others whose MR and associated symptoms are more severe, surgical treatment may be needed to repair or replace the damaged valve.

In the past, this was accomplished through open heart surgery, a major surgical procedure involving a large incision in the chest and extensive recovery. Fortunately, a far less-invasive treatment option for MR is now available in the form of the MitraClip, a small clip that is attached to the mitral valve, allowing it to close more fully and reduce regurgitation. Unlike other surgical options, the MitraClip is a form of transcatheter mitral valve repair.  Rather than requiring incisions in the chest, the clip is guided and positioned through a catheter placed in the blood vessel of groin. In clinical studies, the procedure has shown reduced hospital stays and a 73 percent reduction in hospital visits for heart failure in treated patients.

Who is a candidate for the MitraClip?

Despite its level of invasiveness, valve repair or replacement through traditional surgery is still preferable when available. However, there are many patients for whom such a surgical procedure could be too dangerous, and in these cases, the MitraClip represents a potential alternative. 

Determining if a patient is a good candidate for the MitraClip procedure involves a detailed screening process including an echocardiogram, electrocardiogram, blood tests, and more.

 

If you suffer from mitral regurgitation, it is important that you understand both the severity of your condition and your treatment options. The cardiologists at Cardiovascular Institute of the South can help you better understand the nature of your condition and which therapies may be most beneficial, including the MitraClip procedure. 

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