Mitral regurgitation (MR) is a condition in which the heart’s mitral valve leaflets do not close tightly. When this happens, blood flows backward from the heart’s left ventricle into the left atrium. The heart must then work harder to push blood through the body, which can cause fatigue, shortness of breath and worsening heart failure. It is the most common type of heart valve insufficiency.
Causes:
The MR causes are broadly classified as ischemic (due to consequences of ischemic heart disease) and non-ischemic. Non-ischemic causes include degenerative (myxomatous disease, leaflet degeneration, and annular calcification), endocarditic, rheumatic, and less common miscellaneous causes (congenital, cardiomyopathy-related, inflammatory, drug-induced, and traumatic).
The common causes of mitral regurgitation are mitral valve prolapse (MVP), ischemic heart disease, Marfan syndrome and rheumatic fever.
There are two types of mitral regurgitation: degenerative and functional. Degenerative mitral regurgitation, also called primary mitral regurgitation, is caused by damage to the mitral valve leaflets. Functional mitral regurgitation, also called secondary mitral regurgitation, is caused by enlargement of the heart due to heart attack or heart failure.
The MitraClip procedure is a catheterization lab procedure using fluoroscopy and echocardiographic guidance. TEE, especially 3D TEE is the most important imaging tool to guide the procedure.