Mitral Valve Disease

Mitral Valve Prolapse, Mitral Stenosis, Mitral Regurgitation

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Overview

Duke cardiologists work with you to manage your mitral valve disease, and our heart surgeons specialize in procedures to repair and replace damaged valves, using minimally invasive techniques when appropriate. Our experience and skill with the latest treatment options ensure you get the right treatment and help improve your quality of life.

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About Mitral Valve Disease

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Diseases that affect the mitral valve -- one of four heart valves that control blood flow through the heart -- can be treated with lifestyle changes and medication in their early stages. These treatments may prevent your disease from progressing. Left untreated, mitral valve disease can affect your quality of life and become life-threatening.

Surgery may become necessary when your mitral valve is significantly narrowed or no longer opens properly (mitral valve stenosis), or when your mitral valve no longer closes properly, causing it to leak and allow blood to flow backward into your heart (mitral valve regurgitation).

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Treatments

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Medications
Medicines can reduce symptoms and lower the risks associated with mitral valve disease. These may include beta blockers to relax blood vessels and improve blood flow, as well as aspirin and/or blood thinners to reduce your risk for blood clots.

Mitral Valve Surgery
If surgery is the best option for you, your doctor may recommend open-heart surgery -- accessing the heart via an incision in the chest -- for the repair or replacement of the mitral valve. Or you may be a candidate for a less-invasive surgical option:

Mini-Thoracotomy: Surgeons access the heart and replace the mitral valve through a small incision between the ribs. The minimally invasive approach may result in less blood loss, lower infection risk, and less scarring. Minimally invasive surgery will also shorten your recovery.

Transcatheter Procedures
Interventional cardiologists insert a thin, flexible tube called a catheter into a blood vessel in your groin. They thread the catheter through your circulatory system to the heart. These procedures may be recommended for patients whose health risks are too high for open-heart surgery.

Balloon Valvuloplasty: Through the catheter, a balloon is placed and inflated to open the narrowed mitral valve.
Percutaneous Mitral Valve Repair: A clip-like device is passed through the catheter and inserted to secure the valve opening. This prevents blood from flowing back into the heart. Our involvement in ongoing clinical trials allows us to expand the use of this device to patients who have moderate disease and lower risk levels.

Hybrid Procedures
When appropriate, we combine valve repair or replacement surgeries with transcatheter procedures in our fully equipped hybrid operating room. Having two procedures at once may reduce your risk for complications and help you recover faster.

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Cardiac Tests

Electrocardiogram (ECG)

Description

Small electrodes are placed on your skin to record your heart’s electrical impulses. The tracings may help identify risk for or prior heart muscle damage.

Echocardiogram

Description

An ultrasound probe is moved over the surface of your chest to capture moving images of your heart. This allows us to determine your heart’s chamber dimensions, shape, valve structures, and overall function.

3D Transesophogeal Echocardiogram

Description

An ultrasound probe passed through your esophagus is used to capture sound waves that create highly detailed, close-up 3D images of your heart’s chamber dimensions, shape, valve structures, and overall function.

Cardiac MRI

Description

Radio waves, magnets, and a computer create still and moving images of your overall heart structure, heart muscle function, blood vessels, and surrounding structures.

Cardiac Catheterization

Description

Flexible tubes called catheters are guided through a blood vessel to your heart to look for blockages and overall heart function. Contrast dye is injected and X-rays are taken to capture images of your heart, coronary arteries, and other blood vessels.

Best Heart Hospital in North Carolina

When it comes to your heart care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cardiology and heart surgery program is nationally ranked, and the highest ranked program in North Carolina, according to U.S. News & World Report for 2022–2023.

Why Choose Duke

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Advanced Tools for Accurate Diagnosis
We use 3D transesophageal echocardiography (TEE) to create highly detailed, up-close images of the valves and chambers as well as the pumping action of your moving heart.

We Offer Repairs and Replacements
When possible, our surgeons opt to repair the mitral valve rather than replace it. As a result, you are less likely to require blood thinners and undergo repeat procedures. Repairing a mitral valve requires expertise and experience that not all surgeons have. Between 2015 to 2021, surgeons at Duke performed an average of almost 300 mitral surgeries per year, with repair of most degenerative valves and replacement of narrowed or stenotic valves

Number of Mitral Valve Repair and Replacement Surgeries at Duke from 2015 - 2021

Source: Duke Health data, 2015-2021

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Award-Winning Care, Better Outcomes

Duke Heart is one of less than 25 Mitral Valve Repair Reference Centers in the U.S. The distinction, awarded by the American Heart Association and Mitral Foundation, recognizes our surgeons’ experience in mitral valve repair surgery, our excellent patient outcomes, and our well-equipped facilities. In addition, Duke University Hospital was given a 2023 Cardiac Surgery Excellence Award from Healthgrades, recognizing "superior clinical outcomes" in heart bypass and heart valve surgeries. Duke also received a three-star rating -- the highest rating available -- from the Society of Thoracic Surgeons, which tracks mitral valve surgery outcomes at participating institutions to assess quality and safety.

Minimally Invasive Valve Treatment Options
Our surgeons are ranked among the world’s leaders in mini-thoracotomy procedures, a minimally invasive technique used for valve repair. The use of smaller incisions, rather than mid-chest incision, reduces blood loss, scarring, and the risk of infection while speeding your recovery time.

Access to Novel Treatments
Duke participates in clinical trials of the latest minimally invasive mitral valve procedures.

A Choice in Heart Valve Replacements
If you need a heart valve replacement, we offer mechanical valves that are made of carbon, as well as tissue valves that are made from animal tissue. We educate you on the pros and cons of each and work with you to determine which option is best for you.

Support for Your Recovery
After mitral valve surgery, our cardiac prevention and rehabilitation team provides a personalized plan for recovery and long-term management of your heart health, including exercise instruction, nutritional counseling, and more.

This page was medically reviewed on 11/15/2021 by

Donald D. Glower Jr., MD | Heart Surgeon