Treatment of mitral regurgitation depends on the severity of the regurgitation, as well as symptoms like breathlessness.
In most cases of mitral valve regurgitation, only a small amount of blood leaks backwards through the valve. If this is the case treatment is not required, beyond regular checkups to monitor the valve and heart function.
In some people the regurgitation worsens: sometimes this is gradual, and in some cases it can be quite sudden. There is increasing data from studies suggesting that people with severe regurgitation due to mitral valve prolapse should not wait until they have symptoms before they have the valve repaired, as their long-term life expectancy is lower if their regurgitation is not corrected. Other signs that repair is needed include worsening heart function (left ventricular ejection fraction <60%), an increase in the size of the heart (Left ventricular end systolic dimension>40mm) and high blood pressure in the lungs (systolic pulmonary artery pressures >55mHg).
Mitral valve repair involves open-heart surgery through either a 3-4 inch incision through the breast bone, or between the ribs. Mitral valve repair is the most effective treatment for mitral valve regurgitation. It is the only treatment shown to restore life-expectancy to normal. The great majority of patients with mitral regurgitation due to prolapse should have a repair not a replacement, as valve replacement is carries a worse long-term survival and complication rate than repair.
More Answers from David H. Adams, MD