Treatment of Mitral Regurgitation at the Clínic

The Hospital Clínic Barcelona has the majority of surgical and percutaneous treatments to address mitral regurgitation. It is a reference hospital for these treatments and has CSUR accreditation for surgical mitral repair. Treatment is always tailored to the patient's needs and valve repair is prioritised over replacement.

It has a multidisciplinary team made up of imaging specialists, interventional cardiologists and cardiac surgeons, who are responsible for a joint approach to valve diseases.

When a diagnosis of non-severe or symptomatic mitral regurgitation is made, clinical follow-up is carried out through the reference cardiology specialist. When mitral regurgitation becomes severe or symptoms appear, a referral is made to the hospital's valvular disease process. As a first step, a telematic evaluation of the case is carried out and the clinical history and tests performed are reviewed. If doubts remain or the study has to be extended, a visit to the complex valvular pathology clinic is made, where any additional tests needed, such as a transoesophageal ultrasound or exercise echocardiography, can be performed to complete the diagnosis.

The multidisciplinary valvular pathology team meets once a week to evaluate complex cases and decide what the best treatment approach for patients may be.

Once the patient is considered for valve treatment, the best approach is decided (surgical or percutaneous) and the rest of the necessary tests are requested. The patient is also scheduled for a visit with the vascular surgeon or interventional cardiologist to find out the status of the arteries (CT or coronary angiography), as well as to assess possible calcification in the access areas using CT. In cases of surgical repair, transoesophageal ultrasound evaluation of the valve may be necessary. For percutaneous treatment, transoesophageal ultrasound is always performed as well as a specific CT scan in the case of a prosthesis.

Even though the valve problem is resolved after the operation, patients must continue with subsequent cardiological follow-up with their reference cardiologist.

There are some cases when it is not possible to operate, despite the patients having severe and symptomatic regurgitation. Both in these cases and in patients with functional mitral regurgitation, collaboration with the heart disease team at our hospital is essential to optimise medical treatment and improve symptoms.