Treatment

Mitral valve regurgitation treatment depends on how severe your condition is, if you're experiencing signs and symptoms, and if your condition is getting worse. The goal of treatment is to improve your heart's function while minimizing your signs and symptoms and avoiding future complications.

A doctor trained in heart disease (cardiologist) will provide your care. If you have mitral valve regurgitation, consider being treated at a medical center with a multidisciplinary team of doctors and medical staff trained and experienced in evaluating and treating heart valve disease. This team can work closely with you to determine the most appropriate treatment for your condition.

Watchful waiting

Some people, especially those with mild regurgitation, might not need treatment. However, the condition may require monitoring by your doctor. You may need regular evaluations, with the frequency depending on the severity of your condition. Your doctor may also recommend making healthy lifestyle changes.

Medications

Your doctor may prescribe medication to treat symptoms, although medication can't treat mitral valve regurgitation.

Medications may include:

• Diuretics. These medications can relieve fluid accumulation in your lungs or legs, which can accompany mitral valve regurgitation.
• Blood thinners. These medications can help prevent blood clots and may be used if you have atrial fibrillation.
• High blood pressure medications. High blood pressure makes mitral valve regurgitation worse, so if you have high blood pressure, your doctor may prescribe medication to help lower it.

Surgery

Your mitral valve may need to be repaired or replaced. Doctors may suggest mitral valve repair or replacement even if you aren't experiencing symptoms, as this may prevent complications and improve outcomes. If you need surgery for another heart condition, your doctor may repair or replace the diseased mitral valve at the same time.

Mitral valve surgery is usually performed through a cut (incision) in the chest. In some cases, doctors may conduct minimally invasive heart surgery, which involves the use of smaller incisions than those used in open-heart surgery.

Doctors at some medical centers may perform robot-assisted heart surgery, a type of minimally invasive heart surgery. In this type of surgery, surgeons view the heart in a magnified high-definition 3-D view on a video monitor and use robotic arms to duplicate specific maneuvers used in open-heart surgeries.

Your doctor will discuss with you whether mitral valve repair or mitral valve replacement may be most appropriate for your condition. He or she may also evaluate you to determine whether you're a candidate for minimally invasive heart surgery or open-heart surgery.

Doctors often may recommend mitral valve repair, as it preserves your own valve and may preserve heart function. However, if mitral valve repair isn't possible, doctors may need to perform mitral valve replacement.

Surgery options include:

Mitral valve repair

Surgeons can repair the valve by reconnecting valve flaps (leaflets), replacing the cords that support the valve, or removing excess valve tissue so that the leaflets can close tightly. Surgeons may often tighten or reinforce the ring around a valve (annulus) by implanting an artificial ring (annuloplasty band).

Doctors may use long, thin tubes (catheters) to repair the mitral valve in some cases. In one catheter procedure, doctors insert a catheter with a clip attached in an artery in the groin and guide it to the mitral valve. Doctors use the clip to reshape the valve. People who have severe symptoms of mitral valve regurgitation and who aren't candidates for surgery or who have high surgical risk may be considered for this procedure.

In another procedure, doctors may repair a previously replaced mitral valve that is leaking by inserting a device to plug the leak.

Mitral valve replacement

If your mitral valve can't be repaired, you may need mitral valve replacement. In mitral valve replacement, your surgeon removes the damaged valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).

Biological tissue valves degenerate over time, and often eventually need to be replaced. People with mechanical valves need to take blood-thinning medications for life to prevent blood clots.

Your doctor can discuss the risks and benefits of each type of heart valve with you and discuss which valve may be appropriate for you.

Doctors continue to study catheter procedures to repair or replace mitral valves. Some medical centers may offer mitral valve replacement during a catheter procedure as part of a clinical trial for people with severe mitral valve disease who are aren't candidates for surgery. A catheter procedure can also be used to insert a replacement valve in a biological tissue replacement valve that is no longer working properly.

Talk to your doctor about what type of follow-up you need after surgery, and let your doctor know if you develop new symptoms or if your symptoms worsen after treatment.