Mitral Valve Disease | Diagnosis & Treatments
How we approach treatment for mitral valve disease
The Congenital Heart Valve Program at Boston Children’s specializes in the care and treatment of mitral valve disease. The disease can present in complex and unique ways. Adding to that complexity, many children have already had surgery and are left with residual mitral regurgitation and stenosis, or other problems. Our team carefully considers two primary approaches when treating mitral valve disease: mitral valve repair and mitral valve replacement. The decision depends on the individual case, taking into account the patient’s condition, the severity of the disease, their heart anatomy, and overall health.
We have the expertise to develop the most appropriate individualized care plan for your child. Using innovative three-dimensional modeling that incorporates two- and three-dimensional cardiac echocardiography, CT scans, and cardiac magnetic resonance imaging (MRI), we can see every aspect of a patient’s mitral valve disease and their heart anatomy before surgery. These perspectives allow us to determine the best surgical approach as we strive to preserve native tissue.
Learn how 3D modeling has transformed the planning of surgery by showing details of a patient’s heart.
Mitral valve repair
Our team believes it is best to repair a diseased mitral valve than replace it with a bioprosthetic (cow or pig) or mechanical valve. Over the past decade, we have made tremendous strides in improving our valve repair techniques, including leaflet-based procedures and chordal procedures. This includes using new and proven catheter techniques that enhance the function of heart valves that were previously thought to be untreatable. Through research and clinical trials, we continue to develop innovative solutions to repair mitral valves in a way that will keep the other parts of the heart strong and healthy.
Mitral valve replacement
When efforts to repair a mitral valve have been exhausted, we then determine the best approach to replacing the diseased valve. Mechanical replacement valves are durable but require a patient to take anticoagulation medication for the rest of their lives. Bioprosthetic replacement valves do not require lifelong anticoagulation, but they may have a limited lifespan and thus require a patient to have more replacement procedures. Also, small prosthetic valves are limited in availability, which means young patients may need more interventions as they grow.
Fetal and infant cardiac intervention for mitral valve disease
We work closely with the Fetal Cardiology Program to detect and diagnose mitral valve disease and any CHD in the fetal stage. Thanks to advanced diagnostic imaging, we can pinpoint the disease and potentially intervene before birth with specialized in utero treatment. We are at the forefront of fetal cardiac care and have performed many interventions.
Some young patients with mitral valve stenosis may benefit from a catheter-based procedure called mitral valve balloon dilation. Our cardiologists and surgeons evaluate how a patient’s heart would respond to this procedure instead of surgery.
