By Kirk McMurtry, MD, Cardiothoracic Surgeon – Virtua Cardiothoracic Surgery

Did you ever wonder what your health care providers are listening for when they place their stethoscope on your heart?

Among other things, they’re checking the sound your heart’s valves make as blood flows through them. An unusual sound, called a murmur, could be a sign of a problem with your mitral valve—the set of “double doors” that controls blood flow from your left atrium to your left ventricle.

Mitral valve disease is quite common, especially as we get older. Valve disease often progresses slowly, and symptoms can be treated with medication and lifestyle changes. Eventually, though, you may need surgery to repair or replace the valve.

Stretched or Stuck

The mitral valve has two flaps, or leaflets, that normally open freely and close tightly during each heartbeat.

There are two main types of mitral valve disease. Regurgitation occurs when the leaflets don’t close tightly and allow blood to leak from the ventricle back into the atrium. Regurgitation is often caused by mitral valve prolapse, a condition where the leaflets stretch more than normal and they bulge like a parachute into the atrium.

With mitral valve stenosis, the leaflets can become stiff and narrow, limiting blood flow. The main cause of mitral stenosis is rheumatic fever, a complication of strep throat. Calcium buildup around the valve ring due to age also can cause the leaflets to stiffen.

Mitral valve disease can develop slowly, and you may feel fine for years. Over time, however, you may develop irregular heart rhythms, pulmonary hypertension, an enlarged heart or block clots, and have a higher risk for heart failure.

Seeing your doctor regularly can help us spot a valve issue early and set up a plan of care.

Minimally Invasive Treatments

 Those with mild valve disease may not need treatment. However, if your symptoms worsen, your doctor may suggest surgery. Options include:

• MitraClip: A tiny clip placed at the end of a catheter is threaded through the blood vessels in the heart. The clip clamps the leaflets of the mitral valve into a more secure position when they're closed, but still allows the valve to open and function.
• Transcatheter mitral valve replacement (TMVR): A catheter is threaded through an artery to insert a new mitral valve inside your heart. Once opened with a special balloon, the new valve pushes aside the old one and begins to work immediately.
• Minimally invasive surgical mitral valve repair (mini-MVR): The surgeon trims excess tissue from the valve flaps to help them seal tightly, adds a ring-like collar at the base of the valve for support and stabilization, or enhances the connections of the valve to the heart.
  
• Balloon valvuloplasty: A balloon placed on the tip of a catheter is guided through the blood vessels to the valve. The inflated balloon expands the leaflets, allowing them to open and close more freely.

We are able to perform many valve procedures minimally invasively, without having to make a large incision in the chest. Patients usually notice the benefits right away, recover more quickly, and have an improved quality of life.

Keeping You—and Your Blood—Headed in the Right Direction

Virtua heart specialists use advanced, minimally invasive procedures like TAVR and MitraClip to treat valve disorders and restore your quality of life.

Performed with only a few small incisions, sometimes aided by the daVinci Robotic Surgical System, our interventional cardiologists and cardiac surgeons can repair or replace valves without separating your breastbone or stopping your heart, resulting in less pain and a quicker recovery.

Request an appointment with one of our heart valve specialists.