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Understanding Heart valves

Written by Padma Sundareson | Medically Reviewed by Dr. Sunil Shroff, MBBS, MS, FRCS (UK), D. Urol (Lond) on Nov 04, 2020
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Understanding Heart valves

Mitral Valve is a bicuspid valve present between the left atrium and the left ventricle.


Human heart is divided into four chambers, with two upper chambers called the atria and two lower chambers called the ventricles. The left side of the heart usually receives oxygenated blood from the lungs and pumps it to the body, while the right side receives de-oxygenated blood from the body and pumps it to the lungs. As the blood is pumped through each chamber, it passes through a one-way valve. Valves are thin, strong flaps called as cusps or leaflets.

Mitral Valve is a bicuspid (two leaves) valve that is present between the left atrium and the left ventricle. Tricuspid Valve is present between the right atrium and right ventricle. These two valves are collectively called as the “Atrioventricular valves”. The semilunar valves are valves that are present between the ventricles and the arteries leaving the ventricles. Aortic valve is present between the left ventricle and aorta. The pulmonary valve or pulmonic valve is present between the right ventricle and the pulmonary artery.

The atrioventricular valves are attached to the inside wall of the ventricle, on small muscles called “papillary muscles”, by fibrous structures called as “chordae tendinae”. These two structures are called the subvalvular apparatus, which prevent the valves from prolapsing into the atrium. When the upper chambers or atria contract the atrioventricular valves opens into the ventricles allowing blood to fill the bottom chamber. The valves close with the increase of pressure in the ventricles before it contracts. The blood is then pumped through the semilunar or aortic valves to the great arteries.


A diseased valve does not allow the unimpeded flow of blood. A narrowed or constricted valve makes it hard for the blood to flow to the next chamber. This is called “Valvular Stenosis”. If the mitral valve were to leak, the blood would get pumped back into the lungs when the ventricles contract through the atrium. This is called “Valvular Insufficiency, Incompetence or Regurgitation”. In both conditions, blood supply to the body is compromised. Mild stenosis or regurgitation may not cause any difference in the heart function. Progression in the disease causes the heart to work harder to keep up with the demand of the body. Incapacitating symptoms occur when left untreated.

Heart Cross Section

Damage to the heart valve and result in a Heart Murmur.

Mitral Valve Regurgitation & Mitral Valve Replacement - Reference

  1. Congenital Mitral Stenosis With or Without Associated Defects - (http://circ.ahajournals.org/cgi/content/full/102/suppl_3/III-166)
  2. Mitral Stenosis - (http://www.emedicine.com/med/topic1486.htm)
  3. Hospitalization statistics for Mitral valve disease: - (http://www.wrongdiagnosis.com/m/mitral_valve_disease/stats.htm#medical_stats)
  4. Congenital Mitral Stenosis - (http://www.emedicine.com/ped/topic2517.htm)
  5. Mitral valve regurgitation - (http://www.nlm.nih.gov/medlineplus/ency/article/000176.htm)
  6. Heart & Vascular Institute (Miller Family) - (http://www.clevelandclinic.org/heartcenter/pub/guide/disease/valve/mvrepairfaq.htm)

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Methods for Mitral Valve Repair: Annuloplasty:In annuloplasty an artificial ring is placed around the annulus of the valve.This ring reinforces the annulus and restores the valve to its normal shape and size. Balloon Valvuloplasty:Balloon valvuloplasty is performed using a catheter, i.e. a very thin flexible tube which can be inserted into the body, with a balloon at the end. The balloon is put inside the valve and is expanded thus stretching the valve and bringing it back to its normal size. For more info: heart-consult.com/articles


Patients with a biological valve may need replacement valve of 10-15 years. Mechanical valves may also fail, so patients should inform their doctor if they have symptoms of valve insufficiency. Patients with mechanical valves must take blood-thinning medication at the end of their lives. Because these medicines increase the risk of bleeding in the body, you should always be used in medical notification bracelet and the doctor or dentist that you are taking anticoagulant medicine. Even if you take anticoagulant medication, you should always inform your doctor and dentist to have had valve surgery. If you have any surgery or dentistry, you should take antibiotics before the procedure. The bacteria can enter the bloodstream during these procedures. If bacteria enter the repair or artificial heart valves, can lead to a serious condition called bacterial endocarditis. Antibiotics can prevent bacterial endocarditis. http://www.insideheart.com/


Mitral Regurgitation also known as mitral insufficiency or mitral incompetence is a disorder affecting the mitral valve of the heart. The cusps or flaps of the mitral valve do not seal tightly in this condition and causes a backflow of blood through the mitral valve from the left ventricle to the let atrium of the heart. The heart valve in this state is referred to as a leaky valve. http://www.heart-consult.com


Various symptoms are
* Shortness of breath.
* Pulmonary edema or fluid accumulation in the lungs.
* Orthopnea or shortness of breath while lying flat.
* Paroxysmal nocturnal dyspnea or Cardiac Asthma
* Decreased exercise tolerance.
* Swollen feet or ankles.

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