Mitral regurgitation is a disease in which the valve between the left atrium and the left ventricle begins to leak, so that blood flows back with each heartbeat. Typical symptoms of mitral regurgitation are increased fatigue, increased shortness of breath in physical exertion, and water retention in the lungs and legs. Mitral regurgitation is also often associated with cardiac arrhythmias such as atrial fibrillation. The disease is associated with a significant reduction in life expectancy and frequent referrals to the hospital.

The condition is particularly dangerous and is particularly common in patients with chronic diseases heart attack. This is indicated by the recent findings of a working group led by Philipp Bartko and Georg Goliasch of the Cardiology Division of the Department of Medicine II. The working group analyzed data from more than 13,000 patients who met the criteria for heart failure and who had undergone a cardiac ultrasound at the Cardiology Division of MedUni Vienna and Vienna General Hospital between 2010 and 2020. Mitral regurgitation can be easily identified by cardiac ultrasound. The working group established a correlation between mortality and patient mitral regurgitation.

“Until now, mitral regurgitation has been interpreted as the progression of heart failure rather than as treatable disease in its own right. The results of the study show that mitral regurgitation is much more common in patients with chronic heart failure than previously thought and has a particularly negative impact on the patient’s long-term prognosis, ”explains Georg Goliasch.

The results of the study were published in the British Medical Journal (BMJ) and provide an impetus to make changes in the approach to diagnosis and treatment.

“The results clearly indicate that even in patients with chronic heart failure, mitral regurgitation should not be interpreted as the progression of heart failure, but as a disease in itself that can be treated,” says Philipp Bartko.

New treatment options make it possible to treat high-risk patients

The fact that until now mitral regurgitation has rarely been treated as a separate disease in patients with chronic heart failure is related to treatment options. “Until a few years ago, the only option to treat mitral regurgitation was open heart surgery. This procedure involves opening the chest and connecting the patient to a heart-lung machine. This type of intervention is much riskier in patients with chronic heart failure“, explains Bartko.

There has been a greater focus on the heart valve disease of recent years. New minimally invasive treatment options have been developed, so it is now possible to treat patients with heart valve disease who could not have been treated previously or for whom treatment would have posed a higher risk. So-called transcater techniques can be performed with much less risk. In minimally invasive procedures, the heart valve is repaired through a femoral vein, and in most cases patients can return home the next day.

Heart valve diseases become more common with age

The results of the working group study indicate that the likelihood of developing a heart valve defect increases with age. Due to the increase lifespan of the general population, Goliasch therefore expects the number of cases of this disease to increase in the near future. He says they are prepared for these challenges at the Vienna General Hospital / MedUni Vienna: “Not only can we repair the mitral valve through a minimally invasive procedure, but also most others color valve leaks and constrictions, such as aortic stenosis or tricuspid valve failure, and replace defective valves with prostheses in a minimally invasive procedure. ”

For some years now, an ultramodern hybrid operating room has been available for these procedures, shared by the Division of Cardiology and the Department of Cardiac Surgery and operated in close collaboration with the Department of Anesthesia, Intensive Care Medicine and Pain Medicine the Division of Vascular Surgery and the Division of Cardiovascular and Interventional Radiology.