Mitral Valve Regurgitation

Mitral regurgitation, a valvular heart disease also known as mitral insufficiency or mitral incompetence, is the abnormal leaking of blood through the mitral valve, from the left ventricle into the left atrium of the heart.

What causes mitral valve regurgitation?

The most common cause of mitral regurgitation in the United States (causing about 50% of primary mitral regurgitation) is myxomatous degeneration of the valve. Myxomatous degeneration of the mitral valve is more common in males, and is more common in advancing age. It is due to a genetic abnormality that results in a defect in the collagen that makes up the mitral valve. Mitral valve disease may be due to rheumatic disease but currently is caused most often by mitral valve prolapse syndrome, a poorly understood phenomena in which the valve slowly becomes thickened, elongated and begins to regurgitate blood back into the upper chamber of the heart causing heart failure. The mitral valve somewhat resembles a parachute in that long chords hold it in place. These chords may rupture and result in sudden worsening of the valve leakage.

How is it treated?

Medical therapy of mitral valve problems involves the use of vasodilators, such as ACE inhibitors, nifedipine, and hydralazine. These would normally be used with individuals who have from hypertension in addition to AI.

Surgical treatment consists of mitral valve repair and mitral valve replacement. Most cases of mitral valve problems can undergo repair of the valve rather than placement of an artificial valve. Repair can be performed in 90-95% of cases of mitral leakage due to prolapse syndrome. This allows for postoperative treatment with simple blood thinners, such as baby aspirin, rather than the more powerful anticoagulant Coumadin required after most valve replacements, which has some potentially serious side effects.