The mitral valve is one of four valves in your heart which regulates blood flow to make sure it is moving in the right direction.
A normal mitral valve has two flaps, also called leaflets.
When the heart pumps, blood forces the flaps open, and blood flows from the left atrium to the left ventricle. The flaps then close tightly again so that blood does not leak backwards, the wrong way, through the valve.
Mitral valve disease is often discovered when a doctor or clinician listens to your heart and hears a murmur. This is a 'whooshing' sound that the blood makes as it travels through a thickened or leaking valve.
The are two main types of mitral valve disease.
Mitral valve regurgitation (leaking)
Mitral valve regurgitation is when the valve does not close properly or tightly enough.
Blood then leaks the wrong way through the heart, back from the ventricle (pumping chamber) into the atrium (top chamber).
Mitral valve stenosis (narrowing)
Mitral valve stenosis is when the flaps become narrowed either because they are thickened or stuck. This means the valve will not open properly and obstructs the flow of blood through the heart, between the left atrium (top chamber) and left ventricle (bottom, pumping chamber).
Mitral valve stenosis can make you tired and breathless. Other symptoms may include dizziness, chest pain or irregular heartbeats, dizziness or chest pain. Some people don't notice symptoms.
Treatments
MitraClip
The Mitraclip procedure is a novel technique to treat certain types of leaky mitral valves. It is especially useful in patients deemed high risk for open heart surgery to repair the leak.
The procedure is carried out via the femoral vein at the top of the leg using a small incision and under general anaesthesia with ultrasound and x-ray guidance. More than 50,000 Mitraclip procedures have been performed internationally.
Royal Papworth teams began implanting Mitrclips in 2020 with very good outcomes.
Mitral valvuloplasty
Mitral valvuloplasty is a durable treatment for some forms of mitral stenosis.
It involves inflation of a balloon, inserted via the femoral vein in the upper leg, inside the valve to expand it and help increase blood flow through it. The incidence of mitral stenosis has decreased in the Western world due to a decrease in rheumatic fever therefore the procedure is now infrequently performed in the UK.
Royal Papworth historically remains one of the highest volume centres nationally with very experienced operators.
Mitral valve surgery
Mitral valve surgery is an operation to repair (with your own tissue) or replace (using animal tissue or a mechanical valve) a narrowed or leaky mitral valve. It helps to relieve breathlessness and help prevent heart failure.
Royal Papworth offers both approaches and has the largest number of successful mitral valve repair operations in the UK.
For patients deemed unsuitable or too much of a risk for open-heart surgery, the two other procedures above are minimally invasive treatment options.