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Who should have surgery to repair a leaking mitral valve?

Ramon Quesada, MD
Cardiology (Cardiovascular Disease)
In many instances, having MVP will not impact your health and requires no treatment. Talk with your healthcare provider about how best to prevent complications from MVP based on your level of risk. If you are prescribed medication, take it as directed.
Anthony L. Komaroff, MD
Internal Medicine
If you are having only a small or trivial amount of leakage of your mitral valve, the chance you will ever need surgery is vanishingly small. In fact, even normal mitral valves leak a little bit, and today's echocardiography equipment is so sensitive that it can detect this small amount of back flow. Mitral valve surgery is necessary only when the leakage (called mitral regurgitation) is substantial. This puts a burden on the heart because it has to "re-pump" the blood that spurts backward into the left atrium with each beat instead of flowing out into the aorta and on to the body. The strain of doing this extra work causes the heart to enlarge over time, which isn't good for the heart or health. It's best to repair or replace the mitral valve before the heart gets too big.

If the regurgitation is significant, most doctors recommend periodic echocardiograms to keep an eye on the leakage and the size of the heart. Surgery isn't recommended unless the left ventricle shows signs of dysfunction or the heart enlarges beyond a certain threshold. The onset of shortness of breath or unusual fatigue are also signs that the mitral valve should be repaired or replaced.
Isaac George, MD
Thoracic Surgery (Cardiothoracic Vascular)
Surgery to repair a leaking mitral valve is indicated if the leak is severe and if the person has symptoms related to the leaking. In the absence of symptoms, there are other factors that may suggest that surgery is better than waiting. These factors include:
  • heart function is reduced
  • heart has become dilated
  • atrial fibrillation
  • high pressure in the lungs
  • the chance for repair is very high (versus replacement of the valve)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.