Mitral Valve Disease

Diseases that affect the mitral valve -- one of four heart valves that control blood flow through the heart -- can be treated with lifestyle changes and medication in their early stages. These treatments may prevent your disease from progressing. Left untreated, mitral valve disease can affect your quality of life and become life-threatening. 

Surgery may become necessary when your mitral valve is significantly narrowed or no longer opens properly (mitral valve stenosis), or when your mitral valve no longer closes properly, causing it to leak and allow blood to flow backward into your heart (mitral valve regurgitation).

Medications
Medicines can reduce symptoms and lower the risks associated with mitral valve disease. These may include beta blockers to relax blood vessels and improve blood flow, as well as aspirin and/or blood thinners to reduce your risk for blood clots.
 
Mitral Valve Surgery
If surgery is the best option for you, your doctor may recommend open-heart surgery -- accessing the heart via an incision in the chest -- for the repair or replacement of the mitral valve. Or you may be a candidate for a less-invasive surgical option:

• Mini-Thoracotomy: Surgeons access the heart and replace the mitral valve through a small incision between the ribs. The minimally invasive approach may result in less blood loss, lower infection risk, and less scarring. Minimally invasive surgery will also shorten your recovery.

Transcatheter Procedures
Interventional cardiologists insert a thin, flexible tube called a catheter into a blood vessel in your groin. They thread the catheter through your circulatory system to the heart. These procedures may be recommended for people whose health risks are too high for open-heart surgery.

• Balloon Valvuloplasty: Through the catheter, a balloon is placed and inflated to open the narrowed mitral valve.
• Percutaneous Mitral Valve Repair (also known as Transcatheter Edge to Edge Repair or TEER): A small, clip-like device is passed through a catheter toward the mitral valve.  Using ultrasound imaging, the doctor uses the clip to grasp the mitral valve leaflets and close the gap causing abnormal backflow of blood in the heart. Our participation in clinical trials of these approved devices allows us to expand the use of this less invasive treatment to patients who have lower surgical risk.

Hybrid Procedures
When appropriate, we combine valve repair or replacement surgeries with transcatheter procedures in our fully equipped hybrid operating room. Having two procedures at once may reduce your risk for complications and help you recover faster.

Advanced Tools for Accurate Diagnosis
We use 3D transesophageal echocardiography (TEE) to create highly detailed, up-close images of the valves and chambers as well as the pumping action of your moving heart.

We Offer Repairs and Replacements
When possible, our surgeons opt to repair the mitral valve rather than replace it. As a result, you are less likely to require blood thinners and undergo repeat procedures. Repairing a mitral valve requires expertise and experience that not all surgeons have. Between 2015 to 2023, surgeons at Duke performed an average of almost 300 mitral surgeries per year, with repair of most degenerative valves and replacement of narrowed or stenotic valves