Our Summary

Degenerative mitral regurgitation, a heart condition that affects at least 24 million people worldwide, is a serious public health issue with a significant impact on life quality and mortality. The condition was responsible for nearly a million disability-adjusted life years and 34,000 deaths in 2019. However, better access to diagnostic tests and prompt treatment, such as heart valve surgery, can greatly improve patient outcomes.

Imaging techniques like echocardiography and cardiac magnetic resonance are very helpful for accurate diagnosis. They also provide important information to help decide the best timing for intervention. Surgical techniques have improved and now allow less invasive treatment that can have lasting results for 20 years or more.

For patients who are considered high risk for surgery and have a suitable anatomy, non-surgical treatments can be a good option. These can provide beneficial results for up to 5 years.

Scientific research has expanded our understanding of the disease and could lead to the development of medications that could slow its progression.

FAQs

  1. What is degenerative mitral regurgitation and how many people does it affect worldwide?
  2. What advances have been made in the diagnosis and treatment of degenerative mitral regurgitation?
  3. What is the expected durability of transcatheter therapies for high-risk patients with suitable anatomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve repair is to follow a healthy lifestyle, including maintaining a balanced diet, regular exercise, and avoiding smoking, as these factors can help improve overall heart health and potentially reduce the risk of complications following surgery. It is also important to attend all follow-up appointments and adhere to any prescribed medications or therapy regimens to ensure the best possible outcome after mitral valve repair.

Suitable For

Patients who are typically recommended mitral valve repair are those with degenerative mitral regurgitation. This condition is a major threat to public health and affects millions of people worldwide. Improving access to diagnostic testing and timely curative therapies such as surgical mitral valve repair can greatly improve outcomes for these patients. Imaging techniques such as echocardiography and cardiac magnetic resonance play a crucial role in accurately diagnosing the condition and determining the most appropriate timing for intervention. Advances in surgical techniques have made minimally invasive treatment options available, with durable results lasting for over 20 years. In select cases, transcatheter therapies can also provide good results for patients who are considered high risk for surgery and have suitable anatomy. Translational science has provided new insights into the pathophysiology of degenerative mitral regurgitation, which may lead to the development of medical therapies to halt the progression of the disease.

Timeline

  • Patient experiences symptoms such as shortness of breath, fatigue, and palpitations, leading to a visit to a healthcare provider.
  • Patient undergoes diagnostic testing such as echocardiography and cardiac magnetic resonance to confirm the diagnosis of degenerative mitral regurgitation.
  • Healthcare provider discusses treatment options with the patient, including surgical mitral valve repair.
  • Patient undergoes pre-operative evaluation and preparation for surgery.
  • Patient undergoes mitral valve repair surgery, either through traditional open-heart surgery or minimally invasive techniques.
  • Patient recovers in the hospital post-surgery, with monitoring for any complications.
  • Patient undergoes cardiac rehabilitation and follow-up appointments with healthcare providers to monitor recovery and assess the success of the repair.
  • Patient experiences improved symptoms and quality of life post-surgery, with long-term durability of the repair lasting for ≥20 years.
  • In select cases, patients may undergo transcatheter therapies as an alternative to surgery, with good results but potentially shorter durability of repairs (up to 5 years).
  • Ongoing research and advancements in translational science may lead to the development of medical therapies to halt the progression of degenerative mitral regurgitation in the future.

What to Ask Your Doctor

  1. What is the cause of my mitral valve regurgitation?
  2. What are the potential risks and benefits of mitral valve repair surgery?
  3. Are there any alternative treatment options to mitral valve repair?
  4. How long is the recovery process after mitral valve repair surgery?
  5. Will I need to take any medications following the surgery?
  6. How often will I need to follow up with you after the surgery?
  7. What lifestyle changes, if any, will I need to make after the surgery?
  8. Are there any restrictions on physical activity or exercise following the surgery?
  9. What are the chances of the mitral valve regurgitation returning after the repair?
  10. Are there any long-term complications or risks associated with mitral valve repair surgery?

Reference

Authors: Delgado V, Ajmone Marsan N, Bonow RO, Hahn RT, Norris RA, Zühlke L, Borger MA. Journal: Nat Rev Dis Primers. 2023 Dec 7;9(1):70. doi: 10.1038/s41572-023-00478-7. PMID: 38062018