Think of your heart as your body’s engine — multiple parts work together to regulate blood flow. One of these essential parts is the mitral valve.
“The mitral valve is one of the four main valves in the heart that separates the left upper chamber from the left lower chamber of the heart,” said Saurabh Sanon, MD, structural heart specialist and director of interventional cardiology research at the UPMC Heart and Vascular Institute.
The mitral valve has two leaflets which open and close to transport oxygen-rich blood from the left upper chamber (left atrium) to the left lower chamber (left ventricle). The mitral valve opens when the heart contracts, allowing blood to pump out to other parts of the body. The valve closes after blood returns to the heart.
When the process doesn’t happen properly, as a result of mitral valve disease, it can lead to heart failure if left untreated, according to Dr. Sanon. UPMC offers innovative treatments for mitral valve disease, such as minimally invasive transcatheter based therapies.
Types Of Mitral Valve Disease
Mitral valve stenosis develops due to narrowing of the valve over time. Most often, this happens when the valve becomes calcified, which means calcium has built up around the valve. Valve calcification and narrowing can prevent the mitral valve from opening properly.
However, complications from rheumatic fever can also lead to mitral valve stenosis, as can external radiation from cancer treatment and congenital abnormalities.
Mitral valve regurgitation (also known as mitral insufficiency) occurs when your mitral valve doesn’t close tight enough. As a result, blood flows backward into the left atrium when it should be pumping out to other parts of the body.
A congenital abnormality known as a “floppy mitral valve” most commonly causes mitral valve regurgitation. Referred to as mitral valve prolapse, this condition is a common cause of mitral valve regurgitation. In rare cases, mitral valve regurgitation can result from a bacterial infection in the bloodstream or even secondary to a heart attack.
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Common Treatments For Mitral Valve Disease
Symptoms resulting from mitral valve disease can be treated with medicine. But treating the actual mitral valve disease requires surgery or a minimally invasive catheter-based procedure.
Traditionally, an open-heart procedure was the only option to surgically treat mitral valve disease. During open heart surgery, doctors make an incision in the chest and separate the breastbone to repair the part of the heart that’s not working properly. In some instances, surgery can be performed by entering the patient’s heart between the ribs.
More recently, transcatheter based therapies have been a minimally invasive alternative to open heart surgery.
“The most modern and least invasive type of definitive therapy for mitral valve disease is transcatheter therapy. This can involve repairing or replacing the mitral valve by utilizing entry through a vein in the leg or sometimes through a small incision in the side of the chest,” Dr. Sanon said.
Transcatheter Based Therapies For Mitral Valve Disease
Transcatheter based procedures for mitral valve stenosis and mitral valve regurgitation involve a catheter being guided to the mitral valve through a vein in the groin.
For patients with mitral valve stenosis, a balloon mounted on a catheter is used to stretch open the narrowed valve and restore optimal blood flow. In special situations, research-based bioprosthetic valves are used to replace the patient’s narrowed mitral valve.
For patients with mitral valve regurgitation, cardiologists can use a medical device called a MitraClip™ to bring the leaflets of the mitral valve together and prevent blood from leaking backward into the left atrium. UPMC performs the highest volume of MitraClip procedures in Pennsylvania.
Symptoms of Mitral Valve Disease
The most common symptom for mitral valve disease is shortness of breath, said Dr. Sanon. However, patients can present with various symptoms related to heart failure.
“Patients can have symptoms such as swelling in the ankles and the legs — these are both also symptoms of heart failure, which develops when a person has a dysfunctional mitral valve,” Dr. Sanon said.
Other signs and symptoms may include:
- Fatigue or difficulty breathing with or without activity.
Why Choose UPMC Heart and Vascular Institute?
Experts at the UPMC Heart and Vascular Institute take a multidisciplinary approach to heart care. Your doctors work as a team to provide world-class, comprehensive care based on your individual needs.
“When a patient is referred for mitral valve therapy at UPMC, they are evaluated by a structural heart expert specializing in treatment of mitral valve disease, and an entire multidisciplinary team of physicians including a cardiac surgeon, cardiac imaging specialists, and cardiac anesthesiologists,” Dr. Sanon said. “We all come together to find the best individualized treatment strategy for each patient.”
As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. To learn more about mitral valve disease treatment options or to schedule an appointment, visit our website or call 1-855-876-2484 (UPMC HVI).
MitraClip™ is a trademark of Abbott.
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.