Treatments and drugs

By Mayo Clinic Staff

Mitral valve regurgitation treatment depends on how severe your condition is, and if it's getting worse. The goal of treatment is to improve your heart's function while minimizing your signs and symptoms and avoiding future complications.

Watchful waiting

Some people, especially those with mild regurgitation, might not need treatment. However, the condition may require monitoring by your doctor. You may need regular evaluations, with the frequency depending on how severe your condition is.

Medications

Medication can't correct a mitral valve deformity. But medications such as diuretics can relieve fluid accumulation in your lungs or legs, which can accompany mitral valve regurgitation. Blood thinners (anticoagulants), which can help prevent blood clots, may be used if you have atrial fibrillation.

High blood pressure makes mitral valve regurgitation worse, so if you have high blood pressure, your doctor may prescribe medication to help lower it. Following a low-salt diet helps prevent fluid buildup and helps control blood pressure.

Surgery

Your mitral valve may need surgical repair or replacement, even if it's not causing symptoms. The American College of Cardiology and the American Heart Association recently issued new guidelines for mitral valve surgery, recommending earlier surgery for some people with primary mitral valve regurgitation — caused by an abnormality of the valve — even if they have no symptoms.

Mitral valve surgery should be done at a high-volume mitral valve surgery center with a reputation of excellence and cardiologists, imaging specialists and cardiac surgeons with experience in treating mitral valve conditions.

Discuss the risks and benefits of surgery with your doctor. Your surgery options include:

  • Valve repair. Mitral valve repair is a surgery that preserves your own valve. For most people with mitral valve damage, repair is preferred over replacement. Surgeons can repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly.

    Frequently, repairing the valve includes tightening or replacing the ring around the valve (annulus). This is called an annuloplasty. Methods of repairing mitral valves without open-heart surgery are being used in select cases.

  • Valve replacement. Your surgeon removes the narrowed valve and replaces it with a mechanical or tissue valve. Mechanical valves, made from metal, are durable but carry the risk of blood clots forming. If you receive a mechanical mitral valve, you'll need to take an anticoagulant medication, such as warfarin (Coumadin), for life to prevent blood clots.

    Tissue valves — which may come from a pig, cow or human deceased donor — may eventually need to be replaced. Your doctor can discuss the risks and benefits of each type of heart valve with you.

Talk to your doctor about what type of follow-up you need after surgery, and let your doctor know if you develop new symptoms or if your symptoms worsen after treatment.

Less invasive techniques

Mitral valve repair or replacement generally requires open-heart surgery under general anesthesia and with the use of a heart-lung bypass machine. Less invasive surgical techniques, such as using a small, lighted tube through a small incision to see the surgical area (percutaneous approach), are being explored for mitral valve surgery.

Minimally invasive cardiac surgery is associated with less pain, a shorter hospital stay and fewer complications. However, the surgery is appropriate only in certain circumstances. Talk to your surgeon to see if this type of surgery might be right for you.

Aug. 28, 2014

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