What Is a Leaky Mitral Valve?
Your heart has four chambers, two on the right and two on the left. Blood flows into the right side of the heart, then to the lungs where it receives oxygen. From the lungs it flows into the left atrium of your heart, then to the left ventricle, before going back out to your body.
The mitral valve is located between the left atrium and left ventricle. It has two “leaflets” that open to allow blood to flow through, then meet in the middle to prevent blood from going back into the atrium. A mitral valve leak occurs when the two leaflets do not meet properly in the middle. As a result, some of the blood “leaks” back into the left atrium or back into the lungs, rather than moving forward into your body.
The mitral valve has multiple parts that must work together properly to prevent mitral valve leaks. Our cardiothoracic surgeons and cardiovascular physicians will first determine what is causing the mitral valve to leak, then decide on the right approach, either to repair or replace the mitral valve.
Mitral regurgitation is another term used to describe a leaky mitral valve that allows blood to leak back into your left atrium instead of moving forward to the left ventricle and out into your body.
Mitral Valve Prolapse
Mitral valve prolapse is one of the most common causes of mitral valve leaks. Prolapse occurs when the leaflets “balloon” up as they close, which causes them to overlap or one to overshoot the other. Mitral valve prolapse is caused by a degenerative heart condition. Your doctor may hear a distinct murmur when listening to your heart with a stethoscope. Our doctors will confirm the diagnosis of mitral valve prolapse using an echocardiogram (echo) imaging test.
Anything that changes the mechanics, size, or shape of your mitral valve can lead to a leaky valve. Other mitral valve changes could be caused by:
- calcium deposits on your mitral valve,
- heart attack, or
Leaky Mitral Valve Symptoms
You may not have any symptoms initially with a mitral valve leak. Or you may only experience mild symptoms similar to other heart rhythm disorders, such as:
- shortness of breath,
- dizziness, especially during exercise or other exertion,
- heart murmur,
- irregular heartbeat (similar to atrial fibrillation or AFib), or
- heart palpitations, especially when lying on your left side.
As the condition progresses, you may experience more serious symptoms associated with heart failure, including:
- swelling in the feet and legs (edema),
- congestion, or
- abdominal bloating.
If you experience any symptoms of an irregular heartbeat or heart problems, it's important to schedule an appointment with a cardiologist.
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Mitral Valve Repair vs. Replacement
There are four different surgeries used for mitral valve leaks:
- Mitral valve repair — This surgical procedure repairs or saves your own mitral valve leaflets so your valve can close properly.
- Transcatheter mitral valve repair — A minimally invasive procedure that uses MitraClip® to repair the most common types of mitral valve leakage. This is recommended for patients who are high risk and cannot undergo traditional mitral valve surgery.
- Mitral valve replacement — A surgical procedure to replace your mitral valve with a synthetic one made from biological or man-made materials.
- Transcatheter mitral valve replacement – A less invasive procedure to place a new valve inside a failing one (from a previous replacement surgery) rather than performing another open-heart surgery. This procedure is not approved for all patients, and a thorough evaluation is crucial.
Your cardiovascular clinical team will determine which procedure is best for you based on the type and complexity of your mitral valve leak. A mitral valve repair or replacement surgery is a significant procedure, but studies have shown that putting off the procedure for too long could cause your left ventricle to weaken and not be able to recover. Your cardiologist and cardiothoracic surgeon will help you determine when surgery is the best choice to avoid further damage.
Success Rates for Mitral Valve Repair & Replacement
For most patients, mitral valve repair—either open-heart surgery or a minimally invasive procedure—is the best option. Mitral valve repair is a very successful procedure, especially when it’s performed by one of our highly experienced surgeons at University of Utah Health. Studies show that the 10-year survival rate for patients who undergo a mitral valve repair or transcatheter mitral valve repair are higher than patients who get a replacement.
Your surgeon may recommend mitral valve replacement surgery if he or she believes that a repair is likely to fail. In some cases, you may have mitral valve repair surgery initially and then get replacement surgery at a later time if the repair does not work or eventually fails.
How to Make an Appointment
Patients who would like to see providers in our Mitral Valve Program can contact the Valve Clinic at 801-585‑7676. You will speak to a coordinator who will schedule an initial appointment for you. A referral is not required to be seen in our Valve Clinic. However, you may get a referral to see our doctors from your primary care physician or another doctor.
Some insurance plans do require a referral from your primary care provider to see a specialist. If your plan requires it, make sure you get a referral so your care will be covered under your plan. Contact your insurance carrier for questions about referral requirements or coverage.
A mitral valve repair or mitral valve replacement surgery usually requires pre-authorization from your insurance carrier. Most insurance plans will cover these surgeries once we obtain pre-authorization.
Hear From Our Patients
Greg Denning has never really liked going to the doctor, and for most of his life he’s been an active person who was able to avoid significant medical care. That started to change one day when he was building a cabin in Wyoming. He started experiencing physical symptoms, like shortness of breath and fatigue, that made his wife worry, especially as his symptoms worsened over time. Then, during a routine physical,
Greg’s primary care doctor noticed signs of a heart problem and immediately sent him to a cardiologist. He was eventually diagnosed with a severe mitral valve leak that would require heart surgery.