Mitral Valve Disease

Mitral valve disease is the most prevalent form of heart valve disease.

The heart has four valves that open and close, alternately, with each heartbeat. All four valves are made of thin leaflets that prevent the blood from flowing backward into the heart and allow it to move forward, feeding the rest of the body. Valvular disease occurs in many forms and can affect any of the four valves of the heart.

The mitral valve is located on the left side of the heart. It lies between the left atrium (the upper heart chamber) and the left ventricle (the lower heart chamber), regulating the flow of blood between these two chambers. The mitral valve has two leaflets (flaps) which open and close to regulate the flow of blood. As the inflow valve for the left ventricle, it closes when the ventricle squeezes blood out to the body and then opens to let more blood into the ventricle. The most common diseases affecting the mitral valve are mitral valve regurgitation and mitral stenosis, which can affect the mitral valve's ability to regulate blood flow.

When a valve leaks (regurgitation), there is backflow of blood, which can cause enlargement and weakening of the heart’s chambers, and eventual heart failure. On the other hand, when a valve fails to open properly (stenosis), blood cannot move across the valve and the heart may not be able to pump enough blood to the body.

These conditions are potentially serious impediments to heart function, often hindering or reversing the natural flow of blood through the heart. Mitral valve disease causes the heart to work harder than normal in order to compensate for the reduction in blood flow. Eventually this will cause a weakening of the heart muscle, which increases the risk of irreversible damage and heart failure.

Someone with mitral valve disease will experience shortness of breath, particularly during exertion, and heart palpitations, weakness and fatigue, chest pain (angina), frequent respiratory infections or coughing sometimes with blood-tinged sputum. These symptoms will reduce one's quality of life and potentially death if left untreated.

Some patients with mitral valve disease have additional heart problems such as coronary disease, atrial fibrillation, or tricuspid valve disease. In addition to treatment for mitral valve disease, they may require procedures such as MAZE for atrial fibrillation, repair of the tricuspid valve, or a heart transplant.

Valvular disease has many causes, including coronary artery disease, congenital defects, advanced age and infection. Rheumatic heart disease, although greatly diminished since the advent of antibiotics to treat streptococcal infections, still affects more than 1 million Americans and causes about 6,000 deaths per year.

NYP/Columbia surgeons now use open surgery, minimally invasive approaches and percutaneous approaches to repair a valve or replace it with a tissue substitute. The Columbia Heart Valve Center offers medical, surgical, and interventional options to treat mitral valve disease; learn more about the Heart Valve Center here.

Dr. Craig Smith – What should I know before I have mitral valve repair or replacement?