Congenital Mitral Valve Disease
(Mitral Valve Regurgitation & Mitral Stenosis)

Nemours Cardiac Center at Nemours/Alfred I. duPont Hospital for Children

1600 Rockland Road, Wilmington, DE 19803 | Get Map & Directions »

Children’s heart conditions can’t be prevented, but a lot can be done to improve and often completely repair their hearts at any age. Thanks to advanced technology and the pediatric heart experts at the Nemours Cardiac Center (based at Nemours/Alfred I. duPont Hospital for Children), most children born with a heart problem — even newborns only hours or days old — can be quickly diagnosed and treated right when it matters the most. At the Cardiac Center, we specialize in early detection and repair of congenital heart defects (also often called, “congenital heart disease”).

If your child’s been diagnosed with congenital mitral valve disease (including mitral valve regurgitation), we’re here to ease your concerns, answer your questions, and give your child the best possible chance for a healthy future.

What Is It?

The mitral valve is the valve that separates the left atrium (where oxygen-rich blood returns from the lung to the heart) from the left ventricle (which pumps blood out to the body). It usually consists of two leaflets (the thin, mobile flaps of the valve) which function like doors that open and close with each contraction of the heart.

Congenital (meaning “present at birth”) mitral valve disease includes a range of problems in which the mitral valve is either:

  • too tight (this is called “mitral stenosis”)
  • too loose (this is called “mitral regurgitation,” “mitral valve regurgitation” “mitral insufficiency” or “mitral incompetence”)

These conditions are usually related to the size of the valve itself or to problems with the leaflets in the valve not opening properly. When the valve is too tight, blood has trouble exiting the lungs and the blood vessels in lungs may develop abnormal thickening and growth. When the mitral valve is too loose and leaks, extra blood gets pushed back into the lungs. Over time, this may result in shortness of breath and trouble breathing, especially with exercise.

Congenital mitral valve disease is different than — and not to be confused with mitral valve prolapse — an abnormality of the valve between the left atrium and left ventricle of the heart that sometimes causes backward flow of blood from the left ventricle into the left atrium. Mitral valve prolapse is a relatively common and typically, if not always, harmless condition.

How Does the Heart Normally Work?

When your child has a congenital heart defect, there’s usually something wrong with the structure of the heart. In order to understand your child’s condition, it can help to know how the heart should work normally.
Learn More About Normal Cardiac Anatomy »

Nemours’ experts at also offer these helpful resources to help both you and your child understand how the heart works:

How & When Is It Diagnosed?

Congenital mitral valve disease may be diagnosed at any age. It’s usually detected when a caregiver hears a murmur or children develop symptoms that are often related to extra blood and fluid in the lungs. An echocardiogram (or “echo,” for short) is then done to look at the valve structure and function. An echo is a completely safe and painless test that uses ultrasound (sound waves) to build a series of pictures of the heart.

How & When Is It Treated?

Depending on the severity, patients with congenital mitral valve disease may need surgery early in life or may not need surgery at all. Surgery may involve repair or sometimes replacement of the valve. In smaller children and babies, it’s usually best to try to repair the valve because there’s no artificial valve (that can be used to replace the faulty valve) that will grow with the child. Older children and young adults are more often at a stage where they can have an adult-sized valve placed that should be able to last for the rest of their life.

There are multiple options for different types of valve replacement, which your Nemours Cardiac Center surgeon will discuss with you.

Options include:
  • mechanical valves made of carbon
  • valves made of animal tissue (called “bioprosthetic” or “tissue” valves)
  • donated human valves (called “homografts”)

All of these are safe options that work well for the children we treat.

Learn More About Heart Surgery »

How Will It Affect My Child Long Term?

When surgery is required very early in life, children often need multiple operations until they’re big enough to have an adult-size valve placed. In addition, when children have a mechanical or carbon valve, they’ll often need to be on medications to thin the blood and prevent clots from forming on the valve. These medications require frequent monitoring and dosage adjustments. Children whose valves have been repaired don’t usually need to stay on blood thinners.

If your child has congenital mitral valve disease, know that at the Nemours Cardiac Center we’re here to give your child the very best, most comprehensive and compassionate care. Our goal is to guide your family, from start to finish, through your child’s heart defect journey — and to help your child live the healthiest, most fulfilling life possible.

Learn More About Congenital Heart Defects »

Heart Murmurs

A heart murmur is an abnormal sound (like a blowing or whooshing) that’s usually detected by a doctor who’s listening to the heart with a stethoscope during a routine exam. Learn More »

Why Choose Us

From our outcomes to our family-centered care, find out all of the reasons why your child’s heart will be in good hands at the Nemours Cardiac Center. Learn More »

Make an Appointment

(800) 416-4441

Insurance We Accept »

Information for Patients

Outpatient Services and Inpatient Units: (302) 651-6660

After 5 p.m. and Weekends:

Cardiac Intensive Care Unit: (302) 651-6644
General Inpatient Unit, 2B: (302) 651-6690


+1 (302) 651-4993

Stories From the Heart

Meet children treated in the Nemours Cardiac Center who know what it’s like to live with a heart problem.

Read Their Inspiring Stories »