Heart Check: Symptoms and Solutions for Mitral Valve Disease


With 100,000 beats every day, your heart pumps about 2,000 gallons of blood to your body. Your mitral valve plays a critical role in this process, regulating the flow of blood between the upper left heart chamber called the atrium, which receives oxygen-rich blood from the lungs, and the left ventricle below it, which pumps blood to all parts of your body.

If the mitral valve becomes too loose or too tight, problems can develop. More than 5.8 million Americans have mitral valve disease, with the greatest numbers over age 65. Recent advances in heart surgery have made it possible to fix or replace the valve without major open heart surgery.

“It’s incredibly important with mitral valve disease that we address the problem early in the disease process, while it’s still reversible,” says cardiothoracic surgeon Mario Castillo-Sang, MD, who recently joined St. Elizabeth Heart and Vascular Institute as an expert in minimally invasive mitral valve surgery.

For those who require surgery, he emphasizes that St. Elizabeth Healthcare is open and safe for elective surgery. Safety requirements and precautions include temperature screening, masks for patients and staff, and expanded decontamination processes. These safety measures will continue for the foreseeable future.

Understanding the Basics of Mitral Valve Disease

A mitral valve that isn’t working properly can cause symptoms such as shortness of breath, fatigue and an irregular heartbeat. Your doctor may be able to hear a heart murmur through a stethoscope.

For many people, there may be no symptoms for years.  Over time, however, mitral valve disease can cause life-threatening complications such as heart failure, stroke, serious irregular heartbeats called arrhythmias, or high blood pressure in the blood vessels of the lungs.

Mitral valve disease can develop with age, causing leakage back into the upper heart chamber. It can also be a defect from birth or a stiffening and narrowing from scar tissue due to illness like rheumatic fever or a heart attack.

Minimally Invasive Treatment Options

“Just 10 years ago, very few people performed minimally invasive mitral valve surgery,” Dr. Castillo-Sang says. “The standard of care for many decades was open heart surgery with a sternotomy [cutting open the breast bone]. Today, I do more than 98 percent of all my mitral valve surgeries for degenerative disease through a one-and-a-half-inch incision in the chest.”

Dr. Castillo-Sang has performed close to 400 minimally invasive mitral valve surgeries and has a national reputation for taking on the most complex cases.

He notes that diseased valves can be repaired or replaced with a minimally invasive technique, but “whenever repairable, the mitral valve should be repaired. That is superior to a replacement, because your own heart valve lasts far longer.”

There are cases, however, where the valve is damaged beyond repair and replacement is the best option.

Another minimally invasive procedure recently developed uses a MitraClip™ device, which is a mitral valve repair technique that’s beneficial for people who are not healthy enough for traditional open heart surgery. The small metal clip is threaded through a catheter in your vein to the heart. It clips together a small area of the mitral valve and lessens mitral valve leakage.

To learn more about treatment options for mitral valve disease, contact the Nurse Navigator at the St. Elizabeth Heart & Vascular Institute Valve Center at (859) 301 8287.