Mitral Valve Abnormalities

Some children are born with mitral valve problems. In many cases, the cause is not clear. Children born with mitral valve problems may have other conditions that need treatment.

• Mitral valve regurgitation can develop in children who have holes in the walls that divide the upper or lower heart chambers (atrial septal defect, ventricular septal defect or atrioventricular septal defect).
• Congenital mitral valve stenosis is usually linked with conditions that block blood flow on the left side of the heart. Rarely, mitral valve stenosis can happen on its own.
• Some children with congenital (present at birth) mitral valve problems are born with other conditions too. For instance, mitral valve prolapse sometimes happens with Marfan syndrome, and some types of mitral valve regurgitation are common in children with Down syndrome.

Some children begin life with a normal mitral valve and then develop problems later on. One cause of mitral valve problems is rheumatic fever, which happens after a strep infection.

• Seattle Children’s team of 40+ pediatric cardiologists diagnose and treat mitral valve abnormalities in children of all ages, from infants to adolescents.
• Our pediatric cardiac surgeons perform more than 500 procedures yearly. Each has deep experience operating on children who need a heart valve repaired or replaced – even young babies.
• We also have a pediatric cardiac anesthesia team and a Cardiac Intensive Care Unit ready to care for children who undergo heart surgery.
• For children with mitral valve stenosis, we are leaders in providing safe and effective catheterization procedures. Typically, these procedures are less painful and have shorter recovery times than surgical treatments.

• See our statistics and outcomes for mitral valve repair and replacement.

• We match your child’s care to their symptoms, and we take into account their age, growth and development. Some children with mitral valve abnormalities need no treatment. Others need medicines or heart valve repair or replacement. Your child’s treatment plan is custom-made for them.
• If your child was born with valve abnormalities, we have a special Adult Congenital Heart Disease Program to meet your child’s long-term healthcare needs. This program, shared with the University of Washington, transitions your child to adult care when they are ready.

• We are committed to your child’s overall health and well-being and to helping your child live a full and active life.
• Whatever types of care your child needs, we will help your family through this experience. We will discuss your child’s condition and treatment options in ways you understand and involve you in every decision.
• Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.
• Seattle Children’s has many resources, from financial to spiritual, to support your child and your family and make the journey as smooth as possible.
• Many children and families travel to Seattle Children’s for heart surgery or other care. We help you coordinate travel and housing so you can stay focused on your child.
• Read more about the supportive care we offer.

• Doctors and scientists at Seattle Children’s are working to advance treatment for mitral valve abnormalities and enhance the quality of life for children who need treatment for valve problems.
• Our surgeons are among the most experienced in the nation with the 15-millimeter St. Jude mechanical valve – small enough for babies – due to our role in clinical trials that led to the U.S. Food and Drug Administration to approve this device.
• For very small babies who need an even tinier option than the St. Jude valve, we are on the leading edge. We offer a Melody valve modified so a surgeon can place it. Usually, a Melody valve is used to replace a different heart valve, the pulmonary valve, and it is placed by cardiac catheterization. Our cardiac surgeons can use modified Melody valves to replace the mitral valve in babies. Then, as the child grows, our catheterization specialists can enlarge the Melody valve to match the child’s needs until their heart is big enough to receive a larger valve. We are also involved in research to develop more “growth valves” – devices that can be placed in small babies and enlarged as they grow.

Most children with mitral valve prolapse do not need treatment because their valve causes no symptoms or problems. If they do have symptoms, like palpitations or chest pain, they may need medicine to relieve these.

In uncommon cases, when a prolapsed valve causes major regurgitation, a child may need surgery to repair or replace the valve.

Depending on how severe it is, this valve problem may be treated with medicine that helps the left ventricle pump better so less blood leaks back into the left atrium. If medicine does not help enough, your child may need surgery to repair or replace their mitral valve.

Mitral valve regurgitation may lead to an arrhythmia. If this happens, your child may need medicines that help control their heartbeat.

If mitral valve stenosis is not treated, blood pressure in the lungs may get too high. This is called pulmonary hypertension. It can cause permanent damage to the lungs and the heart, including heart failure.

To prevent damage, some children can have a procedure to open their mitral valve. We do this in the catheterization lab. The doctor inserts a balloon through the valve. When they inflate the balloon, it stretches the valve open. Then they remove the balloon. This is called balloon valvuloplasty.

Some children may need surgery to replace their mitral valve.