How Regurgitation Is Corrected

Mitral valve regurgitation (MR) is a condition in which the mitral valve, one of the valves in the heart, does not close tightly during the cardiac cycle, allowing the blood to flow backward. Since the blood is not moving as efficiently as it should through the heart and the body, MR will affect quality of life. As many as one in five people over the age of 55 may have some level of MR. It has been estimated that more than one in eight people aged greater than 75 years old have at least moderate heart valve disease, a population expected to quadruple in the next 50 years. Furthermore, many patients with heart failure are found to have moderate to severe MR. Severe regurgitation can lead to heart failure.

Many people have mild MR for several years and are monitored by their physician. The heart is often able to compensate for the mild regurgitation during this time. People who experience symptoms that interfere with normal activities, or who have worsening symptoms, may require treatment. Some common symptoms are:

  • Shortness of breath, especially with exertion or lying down
  • Fatigue, especially during times of increased activity
  • Lightheadedness
  • Cough, especially at night or when lying down
  • Heart palpitations — sensations of a rapid, fluttering heartbeat
  • Swollen feet or ankles
  • Heart murmur
  • Excessive urination

In 2007 at Johann Wolfgang Goethe University in Frankfurt Germany a patient entered the study with 2+ MR and an Ejection Fraction (EF) of 38%. The patient received bypass surgery to correct blocked arteries and immediately prior to the surgery the patient was treated with the Guided Delivery Systems Accucinch® device placed through a surgical incision. After 3 years the patient is alive and well with no significant evidence of MR and an EF of 62%, a tremendous improvement from his pre-study condition. We intend to duplicate these results in a large number of patients using a percutaneous delivery.

Treatment

The goal of treatment is to restore the heart’s efficiency and improve the patient’s quality of life. There are no drugs currently available to treat mitral valve regurgitation. Physicians may prescribe medicine to reduce high blood pressure or reduce fluid volume in the body; these actions reduce the burden on the heart, but do not treat MR.

For some patients, the best treatment may be open heart surgery to restore mitral valve function or even replace the mitral valve. Surgery can be effective, though it carries the significant risks and potentially long recovery time associated with open-chest, heart-lung bypass procedures. For most patients with MR, open heart surgery is not an option. For more information about mitral valve regurgitation, please consult Medline Plus, a service of the U.S. National Library of Medicine and the U.S. National Institute of Health: http://www.nlm.nih.gov/medlineplus/ency/article/000176.htm