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How is Mitral Valve Prolapse Treated?

Most people who have mitral valve prolapse (MVP) don't need treatment because they don't have symptoms and complications.

Even people who do have symptoms may not need treatment. The presence of symptoms doesn't always mean that the backflow of blood through the valve is significant.

People who have MVP and troublesome mitral valve backflow may be treated with medicines, surgery, or both.

The goals of treating MVP include:

  • Correcting the underlying mitral valve problem, if necessary
  • Preventing infective endocarditis, arrhythmias, and other complications
  • Relieving symptoms

Medicines

Medicines called beta blockers may be used to treat palpitations and chest discomfort in people who have little or no mitral valve backflow.

If you have significant backflow and symptoms, your doctor may prescribe:

  • Blood-thinning medicines to reduce the risk of blood clots forming if you have atrial fibrillation.
  • Digoxin to strengthen your heartbeat.
  • Diuretics (fluid pills) to remove excess sodium and fluid in your body and lungs.
  • Medicines such as flecainide and procainamide to regulate your heart rhythms.
  • Vasodilators to widen your blood vessels and reduce your heart's workload. Examples of vasodilators are isosorbide dinitrate and hydralazine.

Take all medicines regularly, as your doctor prescribes. Don't change the amount of your medicine or skip a dose unless your doctor tells you to.

Surgery

Surgery is done only if the mitral valve is very abnormal and blood is flowing back into the atrium. The main goal of surgery is to improve symptoms and reduce the risk of heart failure.

The timing of the surgery is important. If it's done too early and your leaking valve is working fairly well, you may be put at needless risk from surgery. If it's done too late, you may have heart damage that can't be fixed.

Surgical Approaches

Traditionally, heart surgeons repair or replace a mitral valve by making an incision (cut) in the breastbone and exposing the heart.

A small but growing number of surgeons are using another approach that involves one or more small cuts through the side of the chest wall. This results in less cutting, reduced blood loss, and a shorter hospital stay. However, not all hospitals offer this method.

Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.

Some of the ways in which your surgeon can repair your mitral valve include:

  • Commissurotomy, in which valve leaflets (the flaps that open and close to keep blood moving in the right direction) that have become fused together are separated to allow the valve to open and close properly;
  • Decalcification, in which the surgeon removes calcium deposits from valve leaflets, allowing them to open and close properly;
  • Quadrangular or triangular resection, in which the surgeon removes a portion of a floppy valve leaflet and sews it back together, allowing the valve to close properly;
  • Annulus support, in which the surgeon sews a ring around the base of your mitral valve (annulus) that has become too wide to reshape and tighten it;
  • Patched leaflets, in which the surgeon patches tears or holes in valve leaflets to prevent leaking;
  • Valvuloplasty, a procedure similar to angioplasty, in which you physician uses a balloon-tipped catheter to widen a narrowed (stenotic) mitral valve. The catheter is inserted into a blood vessel through a small incision in the groin, advanced to the heart, positioned inside the narrowed portion of the valve, and inflated. As the balloon inflates, it pushes the walls of the mitral valve out, widening it and allowing more blood to flow through it after the balloon is removed.
  • MitraClip® insertion, which is a newer type of mitral valve repair. A physician inserts a catheter through a small needle puncture in the vein in the groin to deliver a small clip that is then attached to the leaflets of the mitral valve. The clip helps the valve by improving closure and reducing blood flow back through the valve (called regurgitation).

If you have a mitral valve condition and are in need of an evaluation and possible surgical treatment, or if you are interested in other clinical trials that are available, talk to your physician or cardiologist about a referral to The Heart Valve Center of Texas​.

Referring physicians may call 469.814.3480 to schedule a patient for evaluation. To learn about current research studies, call 469.814.4720.

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