Your Incision Should Be Your Decision™
Mitral valve second opinion
A cardiac surgeon and cardiologist independently review the records and imaging required for your case, then explain which of repair, replacement, TEER, surveillance, or combined treatment belongs in the discussion.
What happens next: A member of our team will call within 2 business hours. During business hours, a same-day conversation with a cardiac surgeon or cardiologist may be arranged only when clinically appropriate and a physician is available.
No referral or travel required. With your authorization, the records team can help obtain what is needed. $495 includes the two-physician written review and co-signed report. Live physician consultation begins with WHITEGLOVE Consult at $995.
The question is not simply “repair, replacement, or TEER?” It is “which options fit this mechanism, this anatomy, and the whole heart?”
Message Us about my decisionMitral disease, in context
Mitral regurgitation can affect the ventricle, atrium, lungs, rhythm, and daily function. Timing and treatment depend on why the valve leaks, what the heart is doing in response, the anatomy, symptoms, other disease, and the options reasonably available. Continue following your treating team’s instructions while seeking clarification.
Degenerative leaflet disease and regurgitation caused by ventricular or atrial remodeling are different problems. Mechanism shapes whether repair, replacement, TEER, medical therapy, or continued monitoring belongs in the discussion.
Symptoms, serial echocardiograms, pulmonary pressures, rhythm, exercise tolerance, and changes in left-ventricular size or function help explain why intervention is—or is not—being discussed now.
The involved leaflet segments, prolapse or restriction, annular dimensions, calcium, coaptation, valve area, and gradient can change which surgical and transcatheter approaches are technically reasonable.
Coronary disease, atrial fibrillation, tricuspid or aortic valve disease, and ventricular dysfunction may favor a combined operation, a staged plan, or a different sequence of care.
Repair, replacement, TEER—or not yet
The purpose of a second opinion is not to favor a catheter, a repair, or an incision. It is to make the mechanism, anatomy, reasons, trade-offs, and uncertainties in your specific record visible.
Surgical repair may preserve the native valve when the mechanism and anatomy make a durable result reasonably achievable. The real question is not whether repair sounds preferable in general—it is how repairable this valve appears and whether the proposed surgeon and center have the relevant experience.
Replacement may be considered when anatomy, calcification, rheumatic disease, tissue destruction, prior procedures, or the expected durability of repair shifts the balance. If replacement is relevant, prosthesis choice and anticoagulation belong in the same conversation.
TEER may be reasonable for selected patients. In primary MR, the discussion generally centers on symptomatic patients with suitable anatomy when surgical risk is high or prohibitive. In secondary MR, persistent severe symptoms despite optimized guideline-directed heart-failure therapy—and CRT when indicated—belong in the candidacy review alongside clinical and anatomic criteria.
Another reasonable discussion may be to complete the workup, optimize relevant medical or rhythm treatment, continue surveillance, or revisit timing. This service does not diagnose or prescribe treatment.
The anatomy and durability view
A useful review looks beyond the immediate recovery to residual regurgitation or stenosis, recurrent disease, reintervention, prosthesis implications, and whether the rest of the heart should be treated at the same time.
Posterior, anterior, bileaflet, restricted, calcified, rheumatic, and previously treated valves do not carry the same technical questions. A review should name what the available imaging does—and does not—show.
A procedure may be technically possible without being the most durable path. Residual regurgitation, stenosis, recurrent disease, reintervention, and the consequences of a failed strategy deserve attention.
In primary MR the valve itself is diseased. In secondary MR, ventricular or atrial remodeling can prevent otherwise structurally normal leaflets from meeting normally. The role of medical, device, catheter, and surgical treatment can therefore differ.
If repair is not considered durable, mechanical and tissue prostheses bring different trade-offs involving anticoagulation, durability, bleeding, thrombosis, lifestyle, and future procedures.
Bypass, atrial fibrillation surgery, tricuspid repair, or another valve procedure may sometimes be addressed during the same operation. That can alter a comparison with a single-lesion catheter procedure.
Recovery, anticoagulation, future procedures, caregiving, work, travel, and tolerance for uncertainty are legitimate inputs to shared decision-making.
WHITEGLOVE Heart Team
Every service level includes both independent reviews and both physician signatures. The physicians confer before the report is finalized.
Repairability · replacement strategy · operative access · combined procedures · lesion-specific program fit
Mechanism · severity · ventricular response · TEER anatomy · medical and rhythm context · surveillance
WHITEGLOVE Insights™
The report is written for patients and families, but grounded in the record set received for the review, current evidence, and two physician reviews.
Download a sample report
The MR mechanism, symptoms, serial testing, ventricular response, treating team’s plan, and the findings driving the discussion—clearly tied to the source record.
The benefits, burdens, technical considerations, and unanswered questions for each path that is clinically reasonable to discuss.
Leaflet involvement, motion, coaptation, annular and subvalvular findings, calcium, valve area, gradients, and the limits of the available imaging.
STS PROM, EuroSCORE II, and AATS considered separately, with the available inputs, missing data, and model limitations made visible.
Patient-facing explanations connect the relevant echo, TEE, catheterization, and imaging findings to the decision in front of you.
A practical check for unresolved imaging, measurements, testing, or clinical context to discuss with the treating team.
Lesion-specific repair experience, valve-program capability, public outcomes where available, geography, and practical considerations when they matter.
A concise set of questions and next steps to bring back to the physicians who know you and will provide your care.
Ready for an independent read?
The $495 option includes both independent physician reviews and one co-signed written report. Live consultation is not included at this level.
What may still be missing
A missing study does not automatically mean care was inadequate. It means the limits of the available review should be visible—and turned into useful questions for the treating team.
MR mechanism and severity, chamber size, ventricular function, pulmonary pressure, other valves, and serial change—not only one number from one study.
When clinically relevant, transesophageal echocardiography can clarify leaflet segments, coaptation, calcium, repairability, and TEER anatomy. Its absence is a question—not automatically an error.
Whether coronary disease is present and whether bypass or another coronary strategy changes the choice or sequence of treatment.
Atrial fibrillation, tricuspid disease, aortic valve disease, pulmonary pressure, and right-ventricular status may change a combined plan.
The clinical and laboratory variables needed for a defensible estimate, plus the limits of every model.
Exercise tolerance, congestion, medication strategy where relevant, kidney and pulmonary status, frailty, and what has changed over time.
Evidence, with its limits visible
Risk estimates describe modeled outcomes for patients with similar inputs. They do not predict an individual result and do not replace clinical judgment.
How it works
The 24-hour written-review clock starts only after all required records and imaging for your case have been received and confirmed complete.
Tell us what you were told, what is already scheduled, and what still feels unresolved. No referral or records are needed to begin.
Upload what you have or authorize the records team to help gather the echocardiography and TEE when available, catheterization, imaging, notes, labs, and proposed plan required for the review.
A cardiac surgeon and cardiologist examine the same record set received and confirmed complete for this review from different clinical perspectives, then confer.
Your WHITEGLOVE Insights™ report is delivered within 24 hours only after all required records and imaging have been received and confirmed complete.
Choose the support you want
Start with the written report. Add physician consultation or concierge access only if it fits your decision. Direct pay; no insurance claim is submitted.
Independent review by both physicians and the co-signed written report.
The written report plus a live consultation with one reviewing physician.
The written report plus both reviewing physicians together on the consultation.
The Heart Team consultation plus concierge access until the day of surgery.
Mitral valve second opinion FAQ
A second opinion can be useful when repair, replacement, TEER, or continued monitoring is being discussed and you want to understand the mechanism of regurgitation, the timing, repairability, alternative approaches, individual risk, or whether another cardiac problem changes the plan. It should not delay urgent or time-sensitive care directed by your treating team.
Sometimes, but not every valve is durably repairable. The answer depends on the actual mechanism, leaflet and annular anatomy, calcification, tissue quality, prior procedures, and experience relevant to that lesion. The review organizes what the available imaging suggests, what remains uncertain, and why repair or replacement is being proposed without promising a repair result.
Primary mitral regurgitation begins with disease of the valve apparatus, such as prolapse or a flail leaflet. Secondary regurgitation occurs because changes in the ventricle or atrium prevent the leaflets from meeting normally. The distinction matters because the roles of repair, replacement, TEER, medical therapy, rhythm treatment, and monitoring can differ.
TEER may be reasonable for selected patients. In primary MR, candidacy generally includes symptoms, suitable anatomy, and high or prohibitive surgical risk. In secondary MR, persistent severe symptoms despite optimized guideline-directed heart-failure therapy and CRT when indicated are considered alongside ventricular status and other clinical and anatomic criteria. A catheter procedure is not automatically better or less appropriate than surgery; the comparison is case-specific.
Yes, when replacement is a relevant option. The report can organize trade-offs involving durability, lifelong anticoagulation, bleeding and clotting considerations, lifestyle, pregnancy considerations when relevant, and possible future procedures. It does not prescribe a prosthesis; the final choice belongs with you and your treating physicians.
The exact record depends on the decision. It commonly includes transthoracic echocardiogram images and reports, TEE images and report when performed or clinically relevant, catheterization or coronary assessment, clinical notes, laboratory results, medication history, rhythm information, and the proposed treatment plan. With your authorization, the records team can help identify, request, and organize what is needed.
A cardiac surgeon and cardiologist independently review the same record set received and confirmed complete for the review, then confer and co-sign one WHITEGLOVE Insights™ report. Both perspectives are included at every service level.
The written report is delivered within 24 hours only after all required records and imaging have been received and confirmed complete. Time spent identifying, requesting, transferring, or collecting records and imaging is outside that 24-hour window.
WHITEGLOVE Insights™ is $495, WHITEGLOVE Consult is $995, WHITEGLOVE Heart Team is $1,495, and WHITEGLOVE Concierge is $2,495. Every option includes the two independent physician reviews and co-signed written report. The service is direct pay and WHITEGLOVEMD does not submit an insurance claim.
No. WHITEGLOVEMD provides independent educational decision support and medical-record review. It does not diagnose, prescribe, perform procedures, provide emergency care, or replace the physicians responsible for your treatment.
Do not delay urgent or time-sensitive treatment while waiting for WHITEGLOVEMD. If you may be experiencing a medical emergency, call 911 immediately.
The decision stays yours
Tell us what you were told, what is already scheduled, and what still feels unclear.
Our team calls within 2 business hours. During business hours, a same-day conversation with a cardiac surgeon or cardiologist may be arranged only when clinically appropriate and a physician is available.