Mending Your Heart

July 15, 2016

Mitral regurgitation is often a problem for seniors, with more than 10 percent of people over 65 affected.* Located between two chambers inside the heart, the mitral valve enables the blood to keep moving forward properly. Sometimes, the valve tissue loses its elasticity, allowing blood to “leak” backward into the heart in “mitral regurgitation.” This is a serious condition that can cause shortness of breath, leg swelling or even heart failure.

Complex mitral valve repair

Farzad Najam, MD, FACS, Director of Cardiac Surgery at GW Hospital’s Cardiovascular Center, specializes in mitral valve repair at GW Hospital. He says repairing the mitral valve is a complex procedure, but he prefers it over replacement if damage is not extensive.

Dr. Najam performs mitral valve repair through open-heart surgery, cutting out part of the valve and “tailoring” it to fit tighter. Preserving the valve maintains the natural relationship between the valve and the heart’s left ventricle. “The heart uses the mitral valve like a piston,” says Dr. Najam. “The two work together in a way that is dif cult to reproduce.”

Mitral valve replacement

Sometimes, the mitral valve can’t be repaired. The skilled multidisciplinary team at the Cardiovascular Center uses information from an echocardiogram (a test that shows pictures inside the heart) along with an operative view to make a decision. “We have to get in there and see the valve with our eyes to tell whether it’s salvageable or not,” says cardiac surgeon Elizabeth Pocock, MD. The Cardiovascular Center at GW Hospital offers both mechanical valves and those made of tissue for replacement procedures. Each one has its benefits.

'“We choose the best type after thoroughly understanding a patient’s symptoms and why a replacement is needed,” says Dr. Pocock.

Early detection of problems

Dr. Najam emphasizes that even small signs of mitral regurgitation shouldn’t be ignored, and problems should be addressed early. “Having surgery during the early stages of a heart condition is preferred,” he says. “Once heart function begins to decline, surgery is much more risky.”

The doctors advises patients who have been diagnosed with valve prolapse (a valve that has slipped out of position), to seek medical attention right away. This is also true for people who experience atrial  brillation, shortness of breath, heart palpitations or if they can’t walk up steps without becoming winded.

*Curr Opin Cardiol, Mitral Valve surgery in elderly patients with mitral regurgitation: repair or replacement with tissue valve? 2013 Mar; 28(2): 164-9; National Institutes of Health