What is Mitral Regurgitation?
The purpose of the heart valve is to ensure blood only moves forward. In mitral valve regurgitation (MR), also known as a leaking mitral valve, blood moves backwards into the heart.
The leaking of the mitral valve increases the effort required by the heart to adequately pump blood to the body. Given the additional stress on the heart, the heart function will deteriorate over time, and the patient will develop symptoms. These symptoms include:
- shortness of breath,
- chest pain, and
- A puncture in the groin; no incision
- Cross from the right to left side of the heart
- Place a clip on the heart to help the valve close better
- Main part of the procedure takes ~1 hours
~80% of patients are discharged home the following day
As reported in the New England Journal of Medicine and the New York Times, appropriately selected patients who underwent the MitraClip procedure experienced significant reduction in mitral regurgitation, improved survival, improved quality of life, and less time in the hospital compared to optimal medical therapy.
- Higher Surgical Risk
- Advanced Age
- Previous Cardiac Surgery
Although they vary by patient. The risks of both procedures are death, bleeding, stroke, infection, and vascular injury. In a typical patient the risk of anyone of these complication is less than 1-2%.
How soon should I get treatment?
Ideally, patients should be treated within 1-3 weeks. Treatment of mitral regurgitation is typically not an emergency. However significant delays can pose a risk of heart failure, hospitalization, and death.
What if I dont get treatment
Symptoms will increase, the heart will begin to fail, and ultimately you will die from this program
Additional Testing and Preperation
- Transthoracic echo
- Pre-admission testing
- Cardiac catheterization -- for some patients Cardiac CT can be performed without the need for cardiac cath
Administrative staff will help find a date for treatment
Nursing coordinatots will provide instruction on preparation
Commonly Performed Procedures
Minimally invasive valve surgery is a specialized approach to treating heart valve disease that avoids the need to "crack the chest." This method uses sophisticated instruments to perform the surgery through a smaller incision at the side of the chest and offers the patients less pain and faster recovery. We perform nearly all of our isolated valve surgeries minimally invasively.
A "bypass" or "cabg" surgery is the most commonly performed heart surgery. It is necessary when the coronary arteries, which provide blood to the heart become narrow preventing sufficient blood from passing through, and thus depriving the heart of oxygen and nutrients. RWJUH has CABG outcomes that exceed national benchmarks.
An aortic aneurysm is a bulging, weakened area in the wall of main blood vessel in the body. The risk of aortic catastrophe, including dissection and rupture, increases dramatically with an aneurysm. Surgery may be recommended when the aorta is larger than 4.5-6 cms. Factors including family history, lifestyle, and need for other heart surgery guide decisions about surgery.
When other treatments are insufficient, a heart transplant is a surgical procedure offered to patients with the most severe damage to the heart. RWJUH is one of a limited number of centers in the US that offer advance heart failure surgery, including heart transplant. Dr. Russo has participated in 500+ successful transplant surgeries.
Transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI), is a minimally invasive approach to the treatment of aortic stenosis. In most patients, it requires no incision and typically patients are discharged within 1 day. Dr Russo is among the most experienced TAVR surgeons in the US.
.The MitraClip procedure does not require opening the chest or stopping the heart. Instead, through a vein in the leg, a thin tube (called a catheter) is guided to the mitral valve The MitraClip device is a small clip that helps your mitral valve to close more completely. Dr. Russo is among the highest volume Mitraclip operators in the Northeast.
PBS: Heart Disease OnCall
Newest heart valve options
Miracle transplant at RWJUH