Symptoms
Anti-arrhythmics to treat atrial fibrillation or other irregular heart rhythms associated with mitral valve stenosis. Antibiotics to prevent a return of rheumatic fever if that's what caused your mitral valve stenosis. You may need valve repair or replacement to treat mitral valve stenosis, which may include surgical and nonsurgical options.
Causes
If your surgeon needs to repair your mitral valve through tiny incisions (without opening up your chest), here are minimally invasive surgical options: Right mini-thoracotomy. The surgeon inserts special instruments and repairs the valve through a 2- to 3-inch incision in a skin fold on the right side of the chest. Partial upper sternotomy.
Prevention
Your doctor will ask about your medical history and give you a physical examination that includes listening to your heart through a stethoscope. Mitral valve stenosis causes an abnormal heart sound, called a heart murmur.
Complications
moderate to severe mitral regurgitation —when the mitral valve doesn't close properly, allowing blood to leak through the valve In addition, PMBV is usually not an option if your mitral stenosis is accompanied by other complex cardiac conditions. After a PMBV procedure, it is possible for mitral stenosis to begin to gradually worsen once again.
What are the treatments for mitral valve stenosis?
What are my minimally invasive mitral valve repair options?
How is mitral valve stenosis diagnosed?
Is pmbv an option for mitral stenosis?
Can mitral valve stenosis get better?
Mitral stenosis can't be cured, but it's possible to manage it. Some treatments, especially valve repair or replacement, can stop or reduce your symptoms for years. Other treatments, such as medication, can also help by preventing complications.
How serious is mitral valve stenosis?
Left untreated, mitral valve stenosis can lead to serious heart complications.
What is the most common cause of mitral stenosis?
The most common cause of mitral stenosis is rheumatic fever — a complication of strep throat. This infection can scar the mitral valve, causing it to narrow.
What medication is used for mitral stenosis?
Mitral Stenosis MedicationAntiarrhythmics.Calcium channel blockers.Anticoagulants.Beta-adrenergic blockers.Antibiotics.Diuretics.
How long can you live with mitral valve stenosis?
If you have developed mild symptoms of mitral stenosis, you may live for at least ten years after diagnosis. However, the calculation of life expectancy is not the same for everyone. Only 80% of patients with mitral stenosis can live up to ten years.
How long can you live with heart valve stenosis?
1 Aortic stenosis is the most common clinically relevant consequence of BAV and usually presents between 50 and 70 years of age. 2 If left untreated, severe aortic valve stenosis is associated with an annual mortality of 25% and the mean duration of survival after diagnosis is 2–3 years.
What is considered severe mitral stenosis?
Key Points: Mitral Stenosis 1. Rheumatic fever is the leading cause of mitral stenosis. 2. A mitral valve area of <1 cm2 is considered severe mitral stenosis.
Is mitral valve stenosis hereditary?
MVP can be familial in 35-50% of cases. In addition to concomitant connective tissue syndromes, MVP has an important heritable component demonstrated in community-based studies and confirmed from recent genome-wide association studies identifying several genetic risk loci.
What surgical treatment options are available for mitral stenosis?
If you and your healthcare provider have decided that it's time for a procedure, you'll be weighing three basic options for the surgical treatment of your mitral stenosis: From most to least often recommended, these are: percutaneous mitral balloon valvotomy (PMBV) mitral commissurotomy. mitral valve replacement.
When does mitral stenosis need surgery?
The most common indication for mitral valve surgery is symptomatic chronic severe primary mitral regurgitation, usually owing to degenerative valve disease, with a left ventricular ejection fraction (LVEF) of >30% (Class I recommendation); mitral valve surgery is indicated in symptomatic patients with severe LV ...
How do you fix a leaky heart valve without surgery?
While this condition can lead to serious health problems, it is treatable – even more so these days due to a minimally invasive procedure using the MitraClip. This FDA-approved device allows physicians to fix faulty heart valves without doing open heart surgery.
Overview
Mitral valve stenosis (sometimes called mitral stenosis) is a disease that causes narrowing or blockage of the mitral valve inside your heart. Over time, this condition can cause heart rhythm problems, a higher risk of stroke, and may lead to heart failure and death.
Symptoms and Causes
The mitral valve is on the left side of your heart and it controls blood flow from the left atrium (upper chamber) to the left ventricle (lower chamber). It's the first valve that blood has to pass through after traveling through your lungs to collect oxygen.
Diagnosis and Tests
Your primary care provider may detect symptoms of mitral stenosis during a regular checkup and refer you to a specialist. A cardiologist will usually do one or more of the following tests to diagnose your case and determine its severity:
Management and Treatment
Mitral stenosis can't be cured, but it's possible to manage it. Some treatments, especially valve repair or replacement, can stop or reduce your symptoms for years. Other treatments, such as medication, can also help by preventing complications.
Prevention
Most cases of mitral stenosis happen because of unrecognized — and therefore untreated — bacterial infections. That means treating those infections can prevent most cases of mitral stenosis. Don’t wait to treat a bacterial infection like strep throat or scarlet fever, and follow your healthcare provider’s instructions closely.
How to treat mitral valve disease?
Mitral valve disease treatment depends on your symptoms, the severity of the condition, and if your condition is getting worse. A doctor trained in heart disease (cardiologist) will provide your care. Treatment may include: Monitoring your condition with regular follow-up appointments. Making healthy lifestyle changes.
How to repair a mitral valve?
To repair a mitral valve, surgeons may patch holes in a valve, reconnect valve flaps (leaflets), separate valve leaflets that have fused, replace the cords that support the valve, or remove excess valve tissue so that the leaflets can close tightly.
What is the procedure to repair a mitral valve?
In mitral valve repair, the surgeon removes and repairs part of the damaged mitral valve to allow the valve to fully close and stop leaking. The surgeon may tighten or reinforce the ring around a valve (annulus) by implanting an artificial ring (annuloplasty band).
How does a balloon tip catheter work?
Sometimes, doctors use a balloon-tipped catheter to repair a mitral valve with a narrowed opening. The catheter is gently guided to the location inside the artery. The doctor then inflates the balloon, which expands the opening of the valve. The balloon is then deflated, and the catheter and balloon are removed.
What is the best way to diagnose mitral valve disease?
Diagnosis. Your doctor may evaluate your signs and symptoms and conduct a physical examination. In a physical examination, your doctor will likely listen for a heart murmur, as this can be a sign of a mitral valve condition. Your doctor may order several tests to diagnose your condition. Echocardiography.
What test is used to check for mitral valve?
Your doctor may order several tests to diagnose your condition. Tests may include: Echocardiography. Sound waves are used to produce video images of your heart in motion. This test helps your doctor get a close look at the mitral valve and how well it's working. Doctors may also use a 3D echocardiogram or another type of echocardiogram called ...
Where is mitral valve surgery done?
Mitral valve surgery is usually performed through a cut (incision) in the chest. In some cases, doctors may perform minimally invasive heart surgery, which involves the use of smaller incisions than those used in open-heart surgery.
How to repair mitral valve?
Surgery to repair the mitral valve may be an option in rare cases of mitral stenosis. Improved blood flow through the valve can be accomplished by surgically separating the valve’s leaflets, removing tissues that obstruct the valve or making adjustments to the fibers ( chords) that hold the base of the valve’s flaps to the heart.
What is the drug used to control an irregular heartbeat?
Anti-arrhythmics: Drugs to control an irregular heartbeat, such as the too-fast heart rhythm of atrial fibrillation (AF) Antibiotics: Drugs to prevent bacterial infection of your heart valve, which you need to take before surgery or teeth cleaning.
Why is valvuloplasty not painful?
This is not a painful procedure because the individual is asleep during the test. It is a very important test because it detects any blood clots that are in the heart. If a blood clot is found, the valvuloplasty usually will not be performed because the risk of causing a stroke would be too high.
How is a valvuloplasty balloon positioned?
The valvuloplasty balloon is passed through the wall and positioned across the narrow mitral valve.
Where is valvuloplasty done?
The valvuloplasty procedure is done in the cardiac catheterization lab using x-ray and a dye that is injected into the bloodstream. Local anesthetic (numbing medicine) is given in the crease of both legs before the tubes are placed into the blood vessels in that area.
Can a cardiologist repair a mitral valve?
If tests show minor or moderate narrowing of the mitral valve, your cardiologist may recommend monitoring your condition during regular check-ups. Some people never require replacement or repair of their mitral valve because they never develop severe mitral stenosis.
Can a mitral valve be opened?
Mitral Valvuloplasty for Mitral Valve Stenosis. Mitral valvuloplasty is a non-surgical procedure that may be used to open a narrow valve within the heart. The procedure can be performed on the same day of admission to the hospital and although some patients may be discharged at the end of the day, people usually stay the night in the hospital.
How to prevent mitral valve stenosis?
The best way to prevent mitral valve stenosis is to prevent its most common cause, rheumatic fever. You can do this by making sure you and your children see your doctor for sore throats. Untreated strep throat infections can develop into rheumatic fever. Fortunately, strep throat is usually easily treated with antibiotics.
What causes a stenosis of the mitral valve?
The main cause of mitral valve stenosis is an infection called rheumatic fever, which is related to strep infections. Rheumatic fever — now rare in the United States, but still common in developing countries — can scar the mitral valve. Left untreated, mitral valve stenosis can lead to serious heart complications.
What is the name of the heart valve that doesn't open?
A normal heart is shown on the left. Mitral valve stenosis — sometimes called mitral stenosis — is a narrowing of the heart's mitral valve. This abnormal valve doesn't open properly, blocking blood flow into the main pumping chamber of your heart (left ventricle).
How does mitral valve stenosis feel?
Symptoms. In mitral valve stenosis, pressure that builds up in the heart is then sent back to the lungs, resulting in fluid buildup (congestion) and shortness of breath. The condition usually progresses slowly over time. You may feel fine with mitral valve stenosis, or you may have mild symptoms for decades.
What is the name of the condition in which the heart's mitral valve is narrowed?
Mitral valve stenosis, shown in the heart on the right, is a condition in which the heart's mitral valve is narrowed. This abnormal valve doesn't open properly, blocking blood flow coming into your left ventricle, the main pumping chamber of your heart. A normal heart is shown on the left.
Why does my mitral valve harden?
Treatment for certain types of cancer that requires radiation to your chest area can sometimes cause the mitral valve to thicken and harden. Other causes. In rare cases, babies are born with a narrowed mitral valve (congenital defect) that causes problems over time.
What to do if you have shortness of breath?
Call your doctor for an immediate appointment if you have fatigue or shortness of breath during physical activity, heart palpitations or chest pain. If you have been diagnosed with mitral valve stenosis but haven't had symptoms, ask your doctor about how often you should have follow-up evaluations.
How to repair mitral valve?
If your surgeon needs to repair your mitral valve through tiny incisions (without opening up your chest), here are minimally invasive surgical options: 1 Right mini-thoracotomy. The surgeon inserts special instruments and repairs the valve through a 2- to 3-inch incision in a skin fold on the right side of the chest. 2 Partial upper sternotomy. This also involves a 2- to 3-inch incision, this time in the upper portion of the sternum. This gives the surgeon easier access to repair the valve. 3 Robotically assisted mitral valve repair. In this case, your surgeon works through a few incisions of about 1 inch or less. With a computer console, the surgeon can control instruments on thin robotic arms. This allows him or her to open the thin sac around your heart to perform the repair.
What is the mitral valve?
The mitral valve allows oxygen-rich blood flowing from the lungs to return to the heart. “The most common valve problem is leakage, also known as mitral valve regurgitation ,” Dr. Kapadia says. “If the blood leaks back into the lungs, it causes you to have shortness of breath.”.
How does a robotic mitral valve repair work?
In this case, your surgeon works through a few incisions of about 1 inch or less. With a computer console, the surgeon can control instruments on thin robotic arms. This allows him or her to open the thin sac around your heart to perform the repair.
What is a Mitraclip?
MitraClip. This is a clip inserted through the groin vein to repair deformed mitral leaflets. It is FDA- approved for patients with severely leaking valves who are at high risk for conventional surgery.
Can mitral valves be repaired?
However, if you have more severe symptoms — shortness of breath or chest pain — the valve will likely need repair or replacement.
Can a surgeon repair a mitral valve?
Medication is sometimes a solution, but surgeons also may use minimally invasive options to repair the mitral valve. Researchers are also investigating several promising mitral valve replacement options. “Percutaneous (through the skin) mitral valve repair and replacement techniques are rapidly growing. They help patients who currently do not have ...
Can mitral valve disease be solved?
While mitral valve disease can lead to severe heart failure, it can often be solved with open surgery. But, what if you are unable to undergo major surgery because of other health issues?
What clinics do we provide mitral valve care?
We provide mitral valve care through our Valvular Heart Disease Clinic and Interventional Cardiology Clinic.
What is it called when the mitral valve in the heart narrows?
How We Can Help You. Mitral valve stenosis occurs when the mitral valve in your heart narrows, restricting blood flow into the main pumping chamber. Your mitral valve may also leak, causing blood to flow back through the valve each time the left ventricle contracts. This condition is called mitral valve regurgitation.
What is a TMVR valve?
Transcatheter mitral valve repair (TMVR): Doctors insert a device called the MitraClip into your valve to relieve the most common type of regurgitation.
What is the treatment for a knot in a valve?
Advanced treatment options, including surgical valve repair, knot replacement, and non-surgical balloon valvuloplasty or MitraClip® treatments for people for whom surgery is not an option.
What artery do you use for angioplasty?
Using the radial artery: Programs like ours traditionally reach the heart through an artery in the groin. We were among the first to use the wrist’s radial artery, for greater comfort, less bleeding, and quicker recovery. Many people undergoing angioplasty can safely go home the same day.
What is the procedure to tighten a loose valve?
Annuloplasty: During this minimally invasive surgery for regurgitation, your doctor places a ring to tighten the loose valve. A Variety of Repair Techniques: Doctors use open-heart surgery to cut away loose leaflet, repair torn cords in addition to annuloplasty.
Can heart valve malfunciton be fixed?
Some valve malfunciton do not pose a threat to your health, so we may suggest careful, regular monitoring. While no medications can fix heart valves, we may recommend drugs to:
Why is mitral valve replacement the last choice?
Mitral valve replacement is the last choice because it carries a higher risk of complications than either PMBV or commissurotomy. Valve replacement is necessary when the mitral stenosis has caused the mitral valve to become very severely damaged or calcified, making the other two procedures impossible.
What is the function of the mitral valve leaflets?
In mitral stenosis, the mitral valve leaflets (flexible flaps that open and close as the heart contracts) become fused together, preventing the valve from opening completely. PMBV attempts to separate the leaflets from one another to relieve the obstruction.
What is PMBV surgery?
In general, PMBV is the surgical procedure your doctor will recommend to address your mitral stenosis unless you have: a left atrial thrombus (blood clot) severe calcium deposits on or near your mitral valve. moderate to severe mitral regurgitation —when the mitral valve doesn't close properly, allowing blood to leak through the valve.
What is a prosthetic valve?
Prosthetic valves can either consist entirely of man-made materials (mechanical valves), or they can be made from the heart valve of an animal, generally a pig (bioprosthetic valve). Deciding which type of artificial valve to use depends on your age and whether you can take the blood thinner Coumadin .
Can mitral regurgitation recur after commissurotomy?
Commissurotomy is often a good option for people who would be candidates for PMBV except for the presence of a left atrial thrombus, valve calcification, or mitral regurgitation. As with the PMBV procedure, mitral stenosis can gradually recur following commissurotomy.
Can mitral stenosis worsen after PMBV?
After a PMBV procedure, it is possible for mitral stenosis to begin to gradually worsen once again. For this reason, even after having this procedure, it is important to have periodic cardiac evaluations with echocardiography. Up to 21 percent of patients who have PMBV will eventually need a second treatment.
Is mitral stenosis surgery a tricky surgery?
The decision to have mitral stenosis surgery is a tricky one , and it has to be carefully individualized.
What is the surgical treatment for mitral stenosis?
Surgical therapy for mitral stenosis consists of mitral valvotomy (which can be either surgical or percutaneous) or mitral valve replacement. The surgical mitral valvotomy approach can be through an closed or open technique; the latter technique is rarely used, except in developing countries, and has largely been replaced by the percutaneous balloon commissurotomy. [ 8]
What is the goal of mitral stenosis?
The goal of medical treatment for mitral stenosis is to reduce recurrence of rheumatic fever, provide prophylaxis for infective endocarditis, reduce symptoms of pulmonary congestion (eg, orthopnea, paroxysmal nocturnal dyspnea), control the ventricular rate if atrial fibrillation is present, and prevent thromboembolic complications. [ 12]
What to do if balloon commissurotomy is not an option?
If percutaneous balloon commissurotomy is not an option, patients should be referred for surgical repair or mitral valve replacement.
What is PMC procedure?
PMC is the procedure of choice for patients with uncomplicated mitral stenosis. Patients with pliable, mobile, relatively thin, minimally calcified mitral leaflets with minimal or no subvalvular stenosis are good candidates for this procedure. A TEE should be performed prior to commissurotomy to clearly define the valve anatomy and exclude the presence of a left atrial thrombus.
How to convert sinus rhythm?
Alternatively, a TEE can be performed to exclude the presence of left atrial thrombus, prior to cardioversion. Patients who are successfully converted to sinus rhythm should receive long-term anticoagulation and antiarrhythmic drugs. Warfarin should be used for anticoagulation. The novel anticoagulants dabigatran and rivaroxaban was approved for nonvalvular atrial fibrillation; these drugs have not been evaluated in patients with heart valve disease. [ 17]
What is a serial follow up test for mitral stenosis?
Serial follow-up testing of a patient with mitral stenosis should be based on whether the results of a test will dictate either a change in therapy or a recommendation for a procedure.
What is the best exercise for mitral stenosis?
In most patients with mitral stenosis, recommendations for exercise are symptom limited. Patients should be encouraged to pursue a low-level aerobic exercise program for maintenance of cardiovascular fitness.
Mitral valve stenosis care at Mayo Clinic
Mayo Clinic doctors trained in heart disease ( cardiologists) collaborate as a multidisciplinary team with heart surgeons ( cardiac surgeons) and other health care professionals to provide you with coordinated, comprehensive care.
Expertise and rankings
Mayo Clinic doctors trained in heart disease ( cardiologists) and heart surgery ( cardiac surgeons) have experience in evaluating and treating people with mitral valve stenosis and other types of heart valve disease. Surgeons in the Valvular Heart Disease Clinic have extensive experience in performing mitral valve repair and replacement.
Locations, travel and lodging
Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.
Costs and insurance
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.
Diagnosis
Treatment
Clinical Trials
Lifestyle and Home Remedies
Coping and Support
- Your doctor will ask about your medical history and give you a physical examination that includes listening to your heart through a stethoscope. Mitral valve stenosis causes an abnormal heart sound, called a heart murmur. Your doctor will also listen to your lungs to check for lung conges…
Preparing For Your Appointment
Overview
Symptoms
Causes
- Mitral valve disease treatment depends on the symptoms, the severity of the condition, and whether the condition is worsening. A doctor trained in heart disease (cardiologist) typically provides care for people with mitral valve disease. Treatment of mitral valve disease might include monitoring the condition with regular follow-up visits. If you h...
Risk Factors
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Complications
- You'll have regular follow-up appointments with your health care provider to monitor your condition. It's also important to make heart-healthy lifestyle changes, including: 1. Eating a heart-healthy diet.Eat a variety of fruits and vegetables, low-fat or fat-free dairy products, poultry, fish, and whole grains. Avoid saturated and trans fat, and excess salt and sugar. 2. Maintaining a hea…
Prevention
- If you have mitral valve disease, here are some steps that may help you manage your condition: 1. Take medications as prescribed.Take your medications as directed by your health care provider. 2. Get support.Having support from your family and friends can help you cope with your condition. Ask your health care provider about support groups that may be helpful. 3. Stay active.It's a goo…