The mitral valve, which is found between the heart's left upper and lower chambers, has two flaps. These flaps open and close to control blood flow through your heart.
Mitral valve regurgitation (MR), or mitral insufficiency, occurs when your mitral valve no longer closes tightly, causing blood to flow the wrong way.
At UPMC, we use the latest technology to diagnose and treat MR. Whether you need medicine or surgery for mitral valve regurgitation, we ensure you get the right care.
Related services:
The mitral valve is a one-way valve between the heart's left upper and lower chambers.
When the heart contracts, the mitral valve's two flaps open to let blood flow from the upper chamber to the lower one.
Mitral regurgitation occurs when the mitral valve doesn't close properly, allowing blood to leak back into the heart's left upper chamber.
MR, or mitral insufficiency, is one of the more common types of heart valve disorders.
The most common cause of MR is mitral valve prolapse.
This occurs when you're born with excess leaflet tissue, known as a "floppy mitral valve." As you age, this condition makes the valve prone to leak.
Mitral valve prolapse causes one or both of the valve's two flaps to stretch or get too large. This may prevent the valve from closing tightly.
Over time, one of the flaps may rupture from its attachment to the heart muscle, leading to worsening valve leakage. This type of mitral regurgitation is called degenerative regurgitation.
Another common cause of MR is endocarditis, a bacterial infection. It often occurs in people with pre-existing mitral valve prolapse.
Bacteria enter the bloodstream — often from dental procedures or poor oral health — and attach to the valve, causing an infection.
Taking antibiotics before you have dental work can help prevent infection.
Other well-known causes of MR include:
People with conditions that can harm the valve or flaps or affect the valve's function are at higher risk for MR. Factors that increase your risk of MR include:
Without treatment, MR can lead to complications such as:
Very rarely, MR caused by severe mitral valve prolapse can lead to sudden death.
If left untreated, mitral regurgitation can cause serious complications that could become life-threatening. It’s important to talk to your doctor if you’re having symptoms of MR and follow your doctor’s treatment recommendations.
You may not be able to control some of your risk factors for mitral valve disease, such as aging and congenital conditions. However, eating a heart-healthy diet, maintaining a healthy weight, exercising regularly, quitting smoking, limiting alcohol, avoiding recreational drugs, and controlling chronic conditions such as high blood pressure and high cholesterol may help to lower your risk.
If you have mitral valve regurgitation, you should take steps to keep your heart healthy and avoid:
MR can exist for years without causing major symptoms. When symptoms do occur, they can include:
You should call a doctor if you have:
Your doctor will ask about your medical history and do a physical exam. MR often causes murmurs or strange sounds of blood flowing through your heart.
During your physical exam, your doctor will:
Your doctor may order further tests if they hear a heart murmur or if you are having symptoms.
Tests your doctor may use to diagnose MR include:
Early diagnosis and treatment of MR can improve your long-term outcomes and survival rate. Your doctor will discuss your prognosis with you.
Goals of treatment for MR are:
For mild MR, medicine and close follow-up with frequent echocardiograms are often all you need.
However, because MR is caused by a mechanical problem, valve repair or replacement is often the best treatment option.
Doctors at UPMC are experts in minimally invasive and surgical techniques for repairing your mitral valve. Your doctor will use the approach that best meets your needs, which may include:
The first line treatment for MR, especially for mitral valve prolapse, is valve repair surgery.
This involves surgery to restore your mitral valve's normal function by rebuilding your existing flaps. We tailor the technique to your anatomy.
Minimally invasive approaches to mitral valve repair involve making a small incision on the front or right side of the chest. This technique is less invasive than open chest surgery.
These smaller cuts to access the heart may lead to:
After minimally invasive mitral valve repair surgery, most people:
After 3-4 weeks of recovery, you can slowly return to normal activity, including driving.
UPMC is a leader in minimally invasive robotic mitral valve repair.
This allows the surgical team to access the mitral valve directly — often through a 2-inch incision — with technical and imaging precision.
It's the preferred treatment for people with isolated MR due to mitral valve prolapse.
Compared to some other types of surgery, robotic mitral valve repair:
UPMC is a leader in transcatheter edge-to-edge repair, a minimally invasive approach to MR valve repair. UPMC experts perform this procedure through a vein in the leg. The surgeon passes a catheter with a clip into the heart and uses the clip to bring the mitral valve's two flaps together.
UPMC uses two commercially available systems: Abbott's MitraClip System and Edwards' Pascal Precision System. Surgeons often use the TEER technique to treat people who are too high risk for heart valve surgery.
Mitral valve repair is always the first approach to treat MR, especially for people with degenerative or "floppy" valves. Our team may perform a mitral valve replacement for moderate to severe cases of MR if repairing the valve isn't an option because of:
We replace the mitral valve with a valve made of either metal flaps (mechanical) or cow or pig tissue (biologic).
At UPMC, the team performs mitral valve repair procedures daily with a more than 90 percent repair rate. Our mitral valve replacement procedures have similar outcomes, with most otherwise healthy patients returning to a normal, active lifestyle after surgery.
People with untreated mitral regurgitation are at higher risk of developing heart failure and other complications that could limit life expectancy. However, after treatment, most people with MR have the same life expectancy as an otherwise healthy person without valve disease.
At the UPMC, we provide a team-based approach to:
Last reviewed by a UPMC medical professional on 2024-10-01.
