Acute mitral regurgitation treatment

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In acute mitral regurgitation secondary to a mechanical defect in the heart (ie: rupture of a papillary muscle or chrordae tendineae), the treatment of choice is urgent mitral valve repair or mitral valve replacement. If the patient is hypotensive prior to the surgical procedure, an intra-aortic balloon pump may be placed in order to improve perfusion of the organs and to decrease the degree of mitral regurgitation.

In comparison to elective surgeries, the mortality rate is higher in emergency mitral valve surgeries with approximately 23% mortality rate in 30 days post-surgery with no bearing of different surgical approaches(repair and replacement) on mortality rate.

If the individual with acute mitral regurgitation is normotensive, vasodilators may be of use to decrease the afterload seen by the left ventricle and thereby decrease the regurgitant fraction. The vasodilator most commonly used is nitroprusside. ACE inhibitors may be useful as oral therapy.