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Dec 06, 2013

Minimally-Invasive Therapies Promising for Treatment of Mitral Regurgitation

Experts provide an overview and recommendations for the use of minimally-invasive procedures as treatment for mitral valve regurgitation.

When it comes to the treatment of heart conditions, minimally-invasive procedures have become increasingly popular in recent years. As technology continues to improve and experts become more experienced with new procedures, so does the safety and efficacy of these treatments. Often times, these novel, minimally-invasive procedures become safer than traditional surgery and patients tend to prefer them over more invasive treatments. So it’s not surprising that experts are hopeful that this trend will carry over into the treatment of mitral regurgitation—a condition that happens when the heart’s mitral valve doesn’t close properly, causing blood to flow backward into the heart.

In a paper recently published in the Journal of the American College of Cardiology, experts provided an overview of where we’re at regarding minimally-invasive therapies for the treatment of mitral regurgitation. They reviewed the latest research on the topic and provided recommendations for making minimally-invasive therapies a reality for the treatment of this condition.

So far, authors report that only one research study has been approved by the U.S. Food and Drug Administration to test a minimally-invasive treatment on patients with mitral regurgitation. Still, initial findings have been promising both in the United States and in Europe. However, authors strongly encourage further research on the topic, as minimally-invasive treatment for mitral regurgitation is much needed, especially for patients that are too high-risk for surgery.

Although it will be a while before such procedures are commonplace in the United States, experts note that there are a few factors which are key to its success. Most importantly, patients undergoing minimally-invasive procedures will require a comprehensive heart team that includes medical experts such as a primary cardiologist, cardiac surgeon and imaging specialist. We will also need to establish a registry of patients undergoing therapies, detailed guidelines for care, a way to assess outcomes (success and risk of the procedure), and conduct extensive training for heart teams that will be performing these new procedures.

Together, these next steps will help set the stage for minimally-invasive procedures as an available treatment for mitral regurgitation and ultimately help patients with this condition live longer, healthier lives.
Read the full paper in the Journal of the American College of Cardiology

Questions for You to Consider

  • What is mitral valve regurgitation?
  • Mitral valve regurgitation means that one of the valves in your heart—the mitral valve—is letting blood leak backward into the heart.

    Heart valves work like one-way gates, helping blood flow in one direction between heart chambers or in and out of the heart. The mitral valve is on the left side of your heart. It lets blood flow from the upper to the lower heart chamber. When the mitral valve is damaged—for example, by an infection—it may no longer close tightly. This lets blood leak backward, or regurgitate, into the upper chamber. Your heart has to work harder to pump this extra blood. Small leaks are usually not a problem. But more severe cases weaken the heart over time and can lead to heart failure.

  • What causes mitral valve regurgitation?
  • There are two forms of mitral valve regurgitation: chronic and acute.

    • Chronic mitral valve regurgitation, the most common type, develops slowly. Many people with this problem may have a valve that is prone to wear and tear. As the person gets older, the valve gets weak and no longer closes tightly. Other causes include heart failure, rheumatic fever, congenital heart disease, a calcium buildup in the valve, and other heart problems.
    • Acute mitral valve regurgitation develops quickly and can be life-threatening. It happens when the valve or nearby tissue ruptures suddenly. Instead of a slow leak, blood builds up quickly in the left side of the heart. Your heart doesn't have time to adjust to this sudden buildup of blood the way it does with the slow buildup of blood in chronic regurgitation. Common causes of acute regurgitation are heart attack and a heart infection called endocarditis.

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