Treatments and drugs

By Mayo Clinic Staff

If you have mild to moderate mitral valve stenosis with no symptoms, you might not need immediate treatment. Instead, your doctor will monitor the valve to see if your condition worsens.

Medications

No medications can correct a mitral valve defect. However, certain drugs can reduce symptoms by easing your heart's workload and regulating its rhythm.

Your doctor might prescribe:

  • Diuretics to reduce fluid accumulation in your lungs or elsewhere.
  • Blood thinners (anticoagulants) to help prevent blood clots. A daily aspirin may be included.
  • Beta blockers or calcium channel blockers to slow your heart rate and allow your heart to fill more effectively.
  • Anti-arrhythmics to treat atrial fibrillation or other rhythm disturbances associated with mitral valve stenosis.
  • Antibiotics to prevent a recurrence of rheumatic fever if that's what caused your mitral stenosis.

    Procedures

    You may need valve repair or replacement to treat mitral valve stenosis. Surgical and nonsurgical options are available.

    Repair with balloon valvuloplasty

    This nonsurgical procedure uses a soft, thin tube (catheter) tipped with a balloon. A doctor guides the catheter through a blood vessel in your arm or groin to the narrowed valve. Once in position, the balloon is inflated to widen the valve, improving blood flow. The balloon is then deflated and the catheter with balloon is removed.

    For some people, balloon valvuloplasty relieves the signs and symptoms of mitral valve stenosis as well as surgery. If your condition worsens over time, you may need the procedure repeated.

    Not everyone with mitral valve stenosis is a candidate for balloon valvuloplasty. Talk to your doctor to decide whether it's an option for you.

    Mitral valve surgery

    Surgical options include:

    • Commissurotomy. If balloon valvuloplasty isn't an option, a cardiac surgeon might perform open-heart surgery to remove calcium deposits and other scar tissue to clear the valve passageway. Open commissurotomy requires that you be put on a heart-lung bypass machine during the surgery. You may need the procedure repeated if your mitral valve stenosis redevelops.
    • Mitral 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 — often eventually need to be replaced. Your doctor can discuss the risks and benefits of each type of heart valve with you.

    Aug. 22, 2014

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