Understanding Mitral Valve Prolapse
Between the heart’s left atrium and left ventricle lies the mitral valve or also known as the inflow valve. During the blood daily cycles, it flows through the lung, picks up the oxygen, into the open mitral valve and to the left ventricle. The two leaflets of the mitral valve snap shut when the heart squeezes and prevents blood from going back to the lungs. After that, blood will be pumped through the aortic valve to the rest of the body.
When the valve between the hearts’s left atrium and left ventricle doesn’t close properly mitral valve prolapse will occur. The valve’s leaflets bulge upward or back into the atrium when the left ventricle contracts. This can sometimes, leads to mitral valve regurgitation or backward blood leakage to the left atrium.
To prevent blood from flowing back into the heart’s upper left atrium, the mitral valve closes during the contraction of the left ventricle. This happens in a normal situation, but when mitral valve malfunctions, the valve’s leaflets are abnormal with extra tissue. Each time the heart contracts, the leaflets are bulging or prolapsing like a parachute into the left atrium. Due to the prolapsing, the valve may not be closed tightly and will cause the blood to travel back into the atrium. However, a small amount of blood may not cause mitral regurgitation; a situation when the blood leaks backwards through the valve.
Click-murmur syndrome is another name for mitral valve prolapse. It gets its name through the murmur sounds of blood flowing back into the atrium as the leaflets billows out. Barlow’s syndrome, Floppy valve syndrome and Ballooning mitral valve syndrome are other names mitral valve prolapse has been described as.
Families with the disorder backgrounds may inherit mitral valve prolapse. Those with connective tissue disorders and people with Marfan syndrome also may risk of catching mitral valve prolapse. Sometimes, syndrome like Ehlers-Danlos, adult polycystic kidney disease and Ebstein anomaly can also be linked to mitral valve prolapse.
People with mitral valve prolapsed have an oversized or thickened flaps of their mitral valve. These people may have defects in their bones of their chest wall, are often thin and also have scoliosis, a curvature in their spine.
Mitral valve prolapse is harmless in most people as it doesn’t require treatment or changes in the lifestyle and does not shorten the life expectancy as well. In some people, it requires treatment as the disease progress but it doesn’t always involve a surgery unless if you have severe mitral valve regurgitation. The left ventricle which is the heart’s main pumping chamber will be risked with severe mitral valve regurgitation. The enlargement will slowly weaken the heart and will prevent it from pumping the blood effectively. In the end, when this goes too long, the heart will be too weak to go for surgery.
There are two options if the doctor suggested for mitral valve surgery. One is repair, while the other one is the replacement of the mitral valve itself.
If one feels that he or she needs to preserve their own valve, mitral valve repair is the option to choose. Two triangular-shaped flaps of tissue are what mitral valve consists of. These flaps or leaflets connect to the heart muscle through the ring around the valve which is the annulus. Through valvuloplasty, the surgeons will modify the original valve to eliminate backward blood flow. This is done by reconnecting the valve leaflets or by removing the excess tissue. By doing this, the leaflets can close tightly and will no longer bulge. Another way is called annuloplasty, where the repair includes tightening or replacing the annulus to fix the issue.
When valve repair is not possible, opt for the second option which is the mitral valve replacement. The damaged mitral valve will be replaced by an artificial prosthetic valve. There are two types of artificial valve; mechanical which are made of metal and tissue which are made from biologic tissue. Mechanical valves may last longer but has some disadvantages. Mechanical valves require anticoagulant medication for the rest of the patients’ life to prevent blood clots formation on the valve. The clots can travel to the brain and causes stroke if it breaks free after the coagulation. On the other hand, valves made of tissue will not have this problem. These valves are also called bioprostheses and are made from animal’s tissue such as a pig’s heart. However, the tissue valves may wear out over time and need replacement but has the advantages of not having to undergo the lifetime medication for a need of an anticoagulant substance.
Under general anesthesia, a mitral valve surgery is usually done by an incision through the sternum. During the procedure, the heart is exposed and connected to a heart – lung machines that assumes the breathing and the blood circulation functions of the patient. The valves will then be replace or repair by the surgeon. The heart function and general recovery are then closely monitored after the operation ended. Though, patients may need to spend one ors more days in an intensive care unit.