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Heart & Vascular Center

Mitral Valve Repair

Mitral valve prolapse is the most common valve abnormality of the heart, affecting up to 10 percent of the population. Most patients with mitral valve prolapse have no symptoms or very mild symptoms and require no treatment.

Understanding Mitral Valve Prolapse

The mitral valve is a one-way valve directing blood from the left atrium—the upper chamber of the heart—to the left ventricle, the main pumping chamber of the heart. The mitral valve, made up of two sail-like structures called leaflets, is supposed to close when the heart beats. This allows blood to leave the left ventricle in the proper direction to be distributed to the rest of the body.

Mitral valve prolapse is a condition in which one or both portions of the valve do not close completely when the heart contracts. This allows the blood to go backwards through the heart, leading to inefficient heart function and possible symptoms.

Most patients with mitral valve prolapse have no symptoms because only a small amount of blood leaks through the abnormal valve. However, when the amount of leakage through the valve becomes excessive, symptoms develop, including:

  • chest pain 
  • fatigue 
  • shortness of breath 
  • dizziness 
  • fainting spells

Other heart conditions also can cause a leaky mitral valve, the most common of which is myocardial infarction, or heart attack. If a heart attack occurs in the portion of the heart where the mitral valve is attached, then the valve becomes dysfunctional and starts to leak. When significant valve leakage is left untreated, the heart gets weaker, enlarges and congestive heart failure sets in.

When symptoms of heart failure develop (shortness of breath, leg swelling, fatigue) or the heart begins to enlarge or weaken, patients are advised to have an operation to treat the leaky mitral valve.

Mitral Valve Repair Providing Better Outcomes for Patients

Traditionally, treatment involved an operation to remove the leaky heart valve and replace it with an artificial valve made of animal tissue (pig or cow) or a mechanical/metallic valve. Mitral valve replacement is one of the first open-heart operations developed and has been performed successfully since the 1960s.

Mitral valve repair is a newer technique used to treat leaking mitral valves whether caused by mitral valve prolapse, heart attacks or other conditions. In mitral valve repair, the surgeon preserves the patient’s own mitral valve tissue and uses a variety of techniques to stop the leakage of blood through the valve. The operation is a more complex and difficult procedure to perform than replacing the valve, requiring additional expertise and training. However, mitral valve repair has many advantages over replacement of the valve. These include better heart function after surgery, fewer risks of future strokes or valve infections, and a lower mortality rate.

Our participation in the FDA approved trials for the Evalve mitral clip has provided another option for patients with a leaky mitral valve (mitral regurgitation). The procedure involves placing a clip on the two mitral valve leaflets, which brings them back together and reduces the amount of regurgitation.  

Surgeons at the Barnes-Jewish & Washington University Heart & Vascular Center have extensive experience in mitral valve repair and perform many of these operations. Hundreds of mitral valve repair operations have been performed with excellent outcomes. More than 80 percent of patients with mitral valve leaks can have a successful valve repair instead of replacement.

To make an appointment with a Washington University heart or vascular specialist at Barnes-Jewish Hospital, call .

Less Invasive Valve Surgery

A highly specialized approach to open heart surgery at Barnes-Jewish Hospital and Washington University allows those with mitral heart valve problems to recover faster with less pain and smaller scars through a minimally invasive procedure called a mini-thoracotomy. Find out more in this video.

 
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