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Mitral Regurgitation

 

 

Mitral Regurgitation

Mitral regurgitation (MR), also known as mitral insufficiency or mitral valve regurgitation, is a heart valve disorder in which the mitral valve doesn’t close properly, allowing blood to flow backward from the left ventricle into the left atrium of the heart and eventually the Lungs. This can be caused by a sudden event, such as a heart attack or a tear in the mitral valve, and it is a medical emergency requiring immediate treatment. However usually this develops gradually and is often caused by long-term damage to the mitral valve, such as from degenerative valve disease, rheumatic fever, or other underlying heart conditions.

Common symptoms of mitral regurgitation may include:

– Fatigue
– Shortness of breath
– Palpitations
– Swelling
– Cough

Complications associated with mitral regurgitation can include heart failure, an enlarged left atrium and left ventricle, and atrial fibrillation (irregular heart rhythms).

Diagnosis typically involves a physical examination, listening to the heart with a stethoscope (which may reveal a “heart murmur”), and various imaging tests, such as echocardiography, to assess the severity and underlying causes of the regurgitation.

Treatment options for mitral regurgitation depend on the severity of the condition and the presence of symptoms:

  • Medications: These may be prescribed to manage symptoms, control irregular heart rhythms, and prevent complications.
  • Open Surgery: Surgical interventions may be recommended for severe cases of mitral regurgitation. Options include mitral valve repair, which aims to restore the valve’s function without removing it, or mitral valve replacement with a mechanical or biological valve.
  • Minimally Invasive Mitral Valve Surgery (MICS): Some patients may be candidates for minimally invasive techniques, which can be less invasive than traditional open-heart surgery. 
  • Cox Maze 4 procedure : Dr.Nikhil says, “Cox Maze IV should be added to mitral valve replacement in the presence of atrial fibrillation, but is frequently omitted by surgeons!”.
  • Incisionless or Transcatheter mitral valve repair (e.g., the MitraClip procedure), can be done. Dr.Nikhil says, “This is an expensive treatment that works only in well selected patients!”. 
  • Incisionless or Transcatheter Mitral Valve replacement (TMVR) : TMVR involves replacing the mitral valve using a catheter inserted through a blood vessel, typically in the groin. Dr.Nikhil says, “TMVR should only be done in patients with previous bioprosthetic mitral valve replacement.”

The choice of treatment depends on the patient’s overall health, the cause and severity of the regurgitation, and other individual factors.

Regular follow-up is essential for individuals with mitral regurgitation to monitor the condition and determine the most suitable treatment plan. Early diagnosis and appropriate management can help prevent complications and improve quality of life.