A leaky heart valve refers to a heart valve that does not close properly. This can make it more difficult for a person’s heart to pump blood. Typically, treatment may involve surgery. However, it may be possible to resolve the issue without surgery in some cases.
A leaky heart valve, or valve regurgitation, occurs when blood flows in the
The heart’s four valves open and close to move blood around the body. If a valve becomes damaged or stretched, it can also become leaky. This can cause blood to flow backward. The heart must then work harder to pump blood, which can place extra strain on this vital organ.
Causes of leaky heart valves can include:
- high blood pressure in the lungs
- congenital anomalies
- enlarged chambers in the heart
- incorrectly functioning leaflets — the openings between valves that allow blood to pass between heart valves
This article discusses approved treatments for leaky heart valves and those currently undergoing clinical trials.
There are different types of leaky heart valves. Currently, medical professionals in the United States can manage
However, while an off-label option, a doctor can treat aortic regurgitation with a
Depending on which valve is causing the issue — the mitral, aortic, pulmonary, or tricuspid valve — several factors may be behind a leaky heart valve. Not all of these are fixable without invasive surgery.
This is a transcatheter edge-to-edge repair device that clips together faulty leaflets, reducing valve leakage. A cardiologist puts these in place using a catheter — a tube through which they insert the mitral clip. The cardiologist threads the catheter to the heart through blood vessels, typically a large blood vessel from the groin.
An individual with a leaky mitral valve would be eligible for a mitral clip procedure on meeting the following criteria:
- They have severe mitral regurgitation.
- They have heart failure that is causing severe symptoms.
- They are not suitable candidates for invasive surgery.
- Their presentation of a leaky heart valve is fixable.
- The referring doctor anticipates a good life expectancy after the procedure.
For some people, heart surgery presents too high a risk. This edge-to-edge device can provide an alternative option for correcting their leaky heart valve.
The risks of this procedure include:
- blood clots
However, a 5-year randomized controlled trial suggests superior safety outcomes compared with surgery.
The trial indicates that edge-to-edge repair reduced the need for follow-up surgery by around the same extent as more intensive surgical treatments, even though more people experienced mitral regurgitation in the year following mitral clip treatment than with surgery.
A clinical trial has been underway since 2014 to measure the safety and effectiveness of the AccuCinch System. This option is for treating secondary mitral regurgitation. This refers to regurgitation that occurs due to issues with the left ventricle or left atrium, and is not a primary issue with the valve itself.
A cardiologist implants this device through a catheter, but instead of the leaflet, the implant attaches to the wall of the ventricle. This aims to reduce strain on the wall of the ventricle, make the ventricle smaller, and make the heart wall stronger without intensive surgery.
While not yet fully approved, the FDA assigned Breakthrough Device status to the AccuCinch System in 2022.
Also known as transcatheter aortic valve implantation (TAVI), this is a minimally invasive procedure that involves inserting a new valve. A surgeon has two options to implant the valve. A transfemoral approach uses a large artery in the groin, while a transapical approach involves a small incision in the chest.
Transcatheter tricuspid valve intervention (TTVI) may be an alternative to medical therapy and surgery. Similar to treating mitral regurgitation with a mitral clip, an edge-to-edge device may also be
A 2022 literature review suggests that TTVI can be a feasible, safe, and effective treatment option for reducing tricuspid regurgitation.
Many people with a leaky heart valve may experience mild-to-moderate symptoms that do not yet warrant valve repair or replacement. For these people,
- relieve symptoms
- manage other heart issues that may be worsening the leaky heart valve
- stop the leaky heart valve from becoming more severe
These medications might include:
- diuretics and vasodilators to reduce high blood pressure and strain on the heart
- drugs that help manage a person’s heart rate
- blood thinners to reduce a person’s risk of blood clots
- antibiotics to manage infections that inflame the heart
Clinical trials into noninvasive methods of treating leaky heart valves are ongoing. At present, only one method — a mitral clip — has FDA approval. Researchers are investigating other methods, some of which are on a fast track to development and safety review but are not yet available.
Depending on the specific type of heart valve regurgitation, there may be less invasive options than surgery to help manage the condition. As such, it is advisable for people to consult with a cardiologist about medications and other less invasive procedures that may be effective.