Mitral valve regurgitation, a Debilitating and Potentially Deadly Pathology.

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Mitral valve regurgitation, a Debilitating and Potentially Deadly Pathology.

Mitral regurgitation results in blood leaking through the mitral valve each time the left ventricle contracts.
This potentially deadly disease is highly prevalent, and can eventually lead to heart failure.

A 65-year-old grandmother and farmer in the Vosges region of France, M., experiences increasing shortness of breath. Initially only during exertion, her symptoms now include difficulty breathing, irregular heartbeat, and fatigue. She learns her mitral valve leaks and requires surgery to repair it with a ring device. The procedure is complex and prolonged, and complications necessitate a second surgery. Recovery takes months, and her condition remains a concern, with the possibility of future leaks requiring additional procedures.

Similarly, P., a 75-year-old retired volunteer, has mitral insufficiency that has worsened, leading to severe heart failure. Due to high surgical risk, he has avoided surgery but eventually suffers a heart attack and succumbs, highlighting the severity of untreated mitral regurgitation.

Globally, 160 million people suffer from mitral insufficiency, with 4 million severely ill. Symptoms vary from mild shortness of breath to severe heart failure and death if untreated.

Two main treatments exist: mitral valve repair or replacement. Both are major, costly surgeries requiring extensive recovery. Repair often needs re-intervention due to recurrence of leaks.

Valve damage can occur via:

• Stenosis: valves do not open sufficiently, blocking blood flow (46%)
• Regurgitation: valves do not close properly (>12%)
• Mixed dysfunction (42%)

Mitral regurgitation occurs when the valve fails to close properly, leading to blood leakage.

Treatment options include:

• Replacement

Mitral valve repair and replacement

Severe regurgitation necessitates surgery. Repair, when feasible, is preferred as it preserves the native valve and offers better long-term outcomes. Commonly, annuloplasty involves implanting a device to reduce annular dilation and restore leaflet coaptation. However, regurgitation recurs in up to 40% of patients within two years, and further surgical intervention may be needed in complex cases.