Mitral Valve Repair Surgery

November 12, 2012

Mitral Valve Repair Surgery

Sometimes problems can occur in the human heart meaning the mitral valve does not fully close and blood escapes into the left atrium.

The mitral valve is part of the heartÂ’s atrioventricular system; it lies between the left atrium and left ventricle and controls blood flow on the left side of the heart. The mitral valve opens and closes with each heartbeat allowing blood to flow from the upper to the lower heart chambers.

Why is a mitral valve repair necessary?

In some patients the mitral valve does not close completely which causes blood to leak back into the left atrium (referred to as a regurgitant or leaking valve), or, it may be that the valve fails to open completely causing a blockage in blood flow (stenosis).

These are two conditions which require mitral valve repair – left untreated complications may include congestive heart failure and irreversible heart damage.

Most cases of damaged mitral valves are degenerative, a natural outcome of the aging process, however, some patients may well have had a damaged valve since birth or the valve may be destroyed as a result of infection, rheumatic fever or ischemic heart disease.

Mitral valve repair – the advantages

Mitral valve repair is the preferred surgical option for a number of reasons -

  • Improved long term survival rate

  • Less invasive than valve replacement surgery

  • Improved quality of life

  • Improved preservation of heart function

  • Lower risk of complications

  • Lower risk of stroke and infection

  • No necessity for post operative blood thinners

  • Long term durability

The procedure

Mitral valve repair procedures are generally carried out via a keyhole approach. An incision of between 2 and 3 inches is made on the right side of the chest (if a surgical robot is used in this procedure the incision will be even smaller). If anatomically necessary this small incision can be made through the centre of the chest. Whichever procedure is followed this is challenging surgery requiring the skills of an experienced surgeon.

Where a prolapse has occurred in the posterior leaflet a triangular resection is the most commonly used technique during mitral valve repair surgery.

The technique required to repair an anterior leaflet prolapsed is more complex requiring as it does the transfer of normal chords from another part of the valve and the creation of artificial chords.

Considerations

Patients requiring mitral valve repair are often found to have an abnormal heart rhythm which will usually be corrected at the same time as the repair using an ablation.

Should the repair fail over time, which happens very rarely, the valves can be repaired once again or replaced.

Existing heart surgery patients

Effective, successful mitral valve repair can, if necessary, be safely carried out on patients who have a variety of existing cardiac problems -

  • Any patient who has already undergone heart surgery

  • A patient who has a damaged mitral valve due to infection

  • Mitral calcification caused by calcium deposits around the valve

Whilst these existing conditions may make a repair more difficult they do not make it impossible. A skilled surgeon will still be able to achieve an excellent outcome for the patient.

Category: Articles