The mitral valve, located between the heart's left upper and lower chambers, has two flaps. These flaps open to allow blood to pass from the atrium to the ventricle. When the heart relaxes and the ventricle fills, the pressure causes the flaps to close.
Mitral valve disease occurs when your mitral valve stops opening and closing properly.
The UPMC Heart and Vascular Institute's Center for Mitral Valve Disease is a leader in diagnosing and treating mitral valve disease, including mitral stenosis and mitral regurgitation.
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The mitral valve is located between the heart's upper left chamber (the left atrium) and the heart's lower left chamber (the left ventricle).
When the heart contracts, the mitral valve's two flaps — or leaflets — open to allow blood to pass from the atrium to the ventricle. When the heart relaxes and the ventricle fills, the pressure causes the flaps to close.
Mitral valve disease is when your mitral valve stops opening and closing properly.
Mitral valve stenosis is a narrowing of the heart's mitral valve, which controls the blood flow through the heart. This prevents your mitral valve from opening properly and reduces blood flow out of the left atrium.
Causes of mitral stenosis include:
Causes of mitral regurgitation include:
Without treatment, mitral valve stenosis can lead to:
Without treatment, mitral regurgitation can lead to:
Our extensive experience allows us to provide the latest treatments for mitral valve disease, including:
Our team-based approach to care includes cardiac surgeons, interventional cardiologists, cardiologists, anesthesiologists, and nurses.
Our team focuses on open communication while working with you, your family, and your personal doctors to provide coordinated care to best meet your needs.
Symptoms of mitral stenosis include:
Symptoms of mitral regurgitation include:
In addition to asking you about your medical history, your doctor at the UPMC Heart and Vascular Institute will perform a physical exam.
Often, mitral valve disease causes murmurs, or abnormal sounds of blood flowing through your heart.
Tests your doctor may use to diagnose mitral valve disease include:
Goals of treatment for mitral valve disease are to limit or eliminate the blockage or leakage of your valve while providing symptom relief and improvement of longevity and quality of life.
If the mitral valve disease is not severe, medications and close follow-up with frequent echocardiograms may be possible. However, since mitral valve disease is a mechanical problem with the flow of blood through your heart, it is often best treated with fixing the valve surgically.
The first line treatment of mitral regurgitation, particularly for mitral valve prolapse, is mitral valve repair. This involves surgically restoring the normal function of the mitral valve by rebuilding one’s existing leaflets using several techniques tailored to the individual anatomy.
At UPMC’s nation-leading Center for Mitral Valve Disease, surgeons perform this operation every day with an overall repair rate over 98 percent.
Mitral valve repair can often be performed using minimally invasive approaches through a small incision on the front of the chest, or, in some cases, through a small incision on the right chest.
Following mitral surgery, most of our patients are removed from the breathing machine very rapidly, if not in the operating room, and stay in the hospital an average of 3 to 5 days before returning home.
For the first 3 to 4 weeks of recovery, activity is strongly encouraged but heavy lifting and driving is restricted. After 3 to 4 weeks of recovery, a gradual full return to normal healthy activity, including driving, is encouraged.
For the treatment of mitral stenosis — or if the valve disease has extensive pathology involving calcium or infection not amenable to repair — a mitral valve replacement is often the first line treatment. This involves surgically clearing the blockage of the valve while preserving the natural anatomy as much as possible.
Mitral valve replacement is performed with either a mechanical valve made of metal leaflets or a biologic valve made of cow or pig tissue.
For select patients, open-heart surgery may be avoided with the use of innovative treatments known as transcatheter procedures.
Experts at UPMC's Center for Mitral Valve Disease perform these procedures via a needle in a vein in the leg and pass special catheters into the heart to treat mitral valve disease.
MitraClip for mitral regurgitation
UPMC is one of the few centers in the country to offer the MitraClip, a minimally invasive approach to repairing valves with mitral regurgitation.
Approved by the U.S. Food and Drug Administration in October 2013, the MitraClip may be used to improve mitral regurgitation symptoms and heart function in selected patients too high risk for surgery.
Balloon mitral valvuloplasty for mitral stenosis
Balloon valvuloplasty is a minimally invasive procedure used to repair mitral valve stenosis.
In valvuloplasty, an interventional cardiologist makes a small incision in your groin and inserts a long balloon-tipped catheter into your heart across the mitral valve.
Once in place, the balloon is inflated thus forcing the flaps of the valve apart. This helps the valve open wider and increases the amount of blood that can pass from the left atrium to the left ventricle.
The UPMC Heart and Vascular Institute offers educational information and videos about mitral valve disease and other heart and vascular diseases and treatments.
Many people find these resources helpful in answering their questions about their mitral valve condition and preparing them for their procedure or diagnostic test.