The mitral valve, found between the heart's left upper and lower chambers, has two flaps. These flaps open and close to control blood flow through your heart.
Mitral valve regurgitation, or mitral insufficiency, occurs when your mitral valve no longer closes tightly, causing blood to flow the wrong way.
At UPMC Heart and Vascular Institute's Center for Heart Valve Disease, we use the latest technology to diagnose and treat this. Whether you need medicine or surgery for mitral valve regurgitation, we make sure you get the right care.
To request an appointment, contact the UPMC Heart and Vascular Institute:
The mitral valve is a one-way valve between the heart's left upper and lower chambers.
When the heart contracts, the mitral valve's two flaps open to let blood flow from the upper chamber to the lower one.
Mitral regurgitation (MR) occurs when the mitral valve doesn't close properly, and blood leaks back into the heart's left upper chamber.
MR, or mitral insufficiency, is one of the more common types of heart valve disorders.
The most common cause of MR is mitral valve prolapse.
This occurs when you're born with excess leaflet tissue, known as a "floppy mitral valve." As you age, this condition makes the valve prone to leak.
Mitral valve prolapse causes one or both of the valve's two flaps are stretch or get too large. This may prevent the valve from closing tightly.
Over time, one of the flaps may rupture from its attachment to the heart muscle, leading to worse valve leakage. This type of mitral regurgitation is degenerative regurgitation.
Another common cause of MR is endocarditis, a bacterial infection. It often occurs in people with pre-existing mitral valve prolapse.
Bacteria enter the bloodstream — often from dental procedures or poor oral health — and attach to the valve, causing an infection.
Taking antibiotics before you have dental work can help prevent infection.
Other well-known causes of MR include:
People with conditions that can harm the valve or flaps or affect the valve's function are at higher risk.
Factors that increase your risk of MR include:
Without treatment, MR can lead to complications such as:
Very rarely, MR caused by severe mitral valve prolapse can lead to sudden death.
At the Center for Heart Valve Disease, we provide a team-based approach to:
MR can exist for years without causing major symptoms.
When symptoms do occur, they can include:
You should call a doctor if you have:
Your doctor at the UPMC Center for Heart Valve Disease will ask about your medical history and do a physical exam.
MR often causes murmurs or strange sounds of blood flowing through your heart.
Tests your doctor may use to diagnose MR include:
Treatment for MR aims to limit or stop your valve leakage. It also relieves symptoms and improves the quality and length of your life.
For mild MR, medicine and close follow-up with frequent echocardiograms are often all you need.
But because MR is a mechanical problem with blood flow, valve repair or replacement is often best.
Doctors at the UPMC Center for Heart Valve Disease are experts in minimally invasive and surgical techniques for repairing your mitral valve.
Your doctor will use the approach that best meets your needs.
Mitral valve regurgitation occurs when the valve separating the left heart chambers doesn't close properly and allows blood to leak backward through the mitral valve. Treatment involves surgically repairing or replacing the mitral valve.
The first line treatment of MR, especially for mitral valve prolapse, is valve repair surgery.
This involves surgery to restore your mitral valve's normal function by rebuilding your existing flaps. We tailor the technique to your anatomy.
At the UPMC Center for Heart Valve Disease, we do this operation every day with a repair rate of over 90%.
Minimally invasive approaches make a small incision on the front of the chest or the right side of the chest.
These smaller cuts to access the heart lead to:
After mitral valve repair surgery, most people:
After three to four weeks of recovery, you can slowly return to normal healthy activity, including driving.
UPMC is a leader in minimally invasive robotic mitral valve repair.
This allows the surgical team to access the mitral valve directly — often through a 2-inch incision — with technical and imaging precision.
It's the preferred treatment for people with isolated MR due to mitral valve prolapse.
Compared to some other types of surgery, robotic mitral valve repair:
UPMC is one of the few centers in southwestern Pa. to offer transcatheter edge-to-edge repair, a minimally invasive approach to MR valve repair.
Experts at UPMC's Center for Heart Valve Disease perform this procedure through a vein in the leg. The surgeon passes a catheter with the clip into the heart to bring the mitral valve's two flaps together.
UPMC uses two commercially available systems: Abbott's MitraClip System and Edwards' Pascal Precision System. Surgeons often use the TEER technique to treat people who are too high risk for heart valve surgery.
Mitral repair is always our first approach, especially for those with degenerative or "floppy" valves.
But we may perform a mitral valve replacement for moderate to severe cases of MR.
This occurs if repairing the valve isn't an option because of:
We replace the mitral valve with a valve made of either metal flaps (mechanical) or cow or pig tissue (biologic).
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