Mitral Valve Disease

Treatment

Treatment options for mitral valve disease may include:

Careful monitoring
Medications
Heart valve surgery (repair or replacement)

Careful monitoring

If tests reveal a mild to moderate condition and the patient has no symptoms, the physician will suggest regular medical checkups to carefully monitor the mitral heart valve so medications can be prescribed or surgery done, if appropriate.

Medications

Medications are available to control pain, reduce the workload on the heart and regulate the heart's rhythm. In some cases, medication may slow progressive mitral valve disease. However, no medications can cure heart valve disease. Mayo Clinic is involved in clinical investigations of ACE inhibitor, angiotensin-blocking and beta-blocking drugs that offer hope to people with mitral valve disease.

Antibiotics prior to dental or surgical procedures are needed by almost everyone with a heart valve defect. Without preventive antibiotics, bacteria can enter the bloodstream during these procedures and lead to a serious bacterial infection of the heart called endocarditis. Read more about endocarditis prevention.

Depending on the nature of the mitral heart valve disease, the following medications may be prescribed:

• Digitalis, which reduces the heart's workload and eases some symptoms.
• Diuretics, which can lower the salt and fluid levels in the body, lowering the pressure at which blood passes through the valves. Diuretics also reduce swelling and ease the heart's workload.
• Anticoagulant medicines, which prevent blood clots, especially in patients who have had heart valve surgery and have a replacement valve made of synthetic material.
• Beta-blockers, which control the heart rate and lower blood pressure.
• Calcium channel blockers, which affect the contractions of muscle tissue in the heart. By lowering blood pressure and reducing the heart's workload, calcium channel blockers may delay the need for heart valve surgery.
• ACE inhibitors, which widen blood vessels, lower blood pressure and decrease the heart's workload.

Mitral valve surgery

Mitral valve regurgitation
The most common reason for surgery is mitral valve regurgitation (leakage), which can result in:

• enlargement of the atrium and sluggish flow of blood, which may lead to the formation of blood clots that could break loose and lodge in the brain, causing a stroke
• less oxygen-rich blood leaving the heart to nourish the body
• enlargement of the left ventricle wall, as it works harder to push blood throughout the body

Regurgitation may be corrected by repairing the abnormal valve leaflet or repairing or replacing the supporting valve structures to allow the valve to close tightly. A prosthetic ring may also be inserted to reshape a deformed valve. Valve flaps (leaflets) may also be modified so that they do not allow blood to flow backwards. Valves with regurgitation are usually repairable and rarely require replacement.

Mitral valve stenosis
By surgically separating or shaving back valve leaflets — called commissurotomy — physicians can eliminate mitral stenosis and improve blood flow. However, usually these valves require replacement.

Read more about mitral valve stenosis and mitral valve surgery at Mayo Clinic.