Mitral Valve Surgery
Mitral Valve Surgery
The mitral valve is situated between the left atrium and left ventricle of the heart. Surgery may be required to repair or replace a leaky or stiff mitral valve.
Mitral valve repair and replacement can be performed through either an open-heart procedure or minimally invasive surgery.
Causes of Mitral Valve Disease
Mitral valve disease has many causes, including rheumatic fever, infection of the heart valves, coronary artery disease, heart failure, autoimmune diseases like lupus, and more. Some forms of mitral valve disease may be congenital.
The risk of developing mitral valve disease can increase due to factors such as old age, the use of certain drugs, and radiation to the chest.
Types of Mitral Valve Disease
Mitral valve disease can result in the following conditions:
- Mitral valve regurgitation: In this condition, the valve becomes leaky, causing some blood to flow back into the left atrium instead of moving forward into the left ventricle. This is often caused by mitral valve prolapse.
- Mitral valve stenosis: In this condition, the valve narrows and is unable to open fully, preventing sufficient blood from flowing through the left atrium into the left ventricle.
Mitral Valve Repair Surgery
Surgery may be required to repair the mitral valve if the patient experiences severe regurgitation, where the left ventricle cannot pump enough blood to the body due to blood leaking back into the left atrium. Over time, this can lead to an enlarged and weakened heart.
Mitral valve repair techniques include:
- Ring annuloplasty: In this procedure, any abnormal section of the valve is removed, and the edges are sutured together. A cloth-covered ring is then placed around the valve.
- Triangular or quadrangular resection: This technique is used for posterior leaflet prolapse by removing the damaged part of the leaflet and sewing the remaining edges together.
- Chordal repair: This technique is used to repair both anterior and posterior leaflet prolapse by replacing some of the chords supporting the mitral valve and attaching new chords.
- Commissurotomy: This surgery involves separating the mitral valve flaps to relieve stenosis.
In cases where the damaged mitral valve cannot be repaired, it must be replaced.
Mitral Valve Replacement Surgery
If the damage to the mitral valve is extensive, a replacement surgery becomes necessary. In this procedure, the diseased valve is removed and replaced with a new one. The replacement valve may be either mechanical or biological.
- Mechanical valve: A man-made valve, typically made from materials like carbon and titanium, replaces the damaged mitral valve.
- Biological valve: The replacement valve is made from animal or human heart tissue.
The surgery typically takes 2 to 4 hours. Afterward, the patient will spend one to two days in the ICU and several more days in the hospital, depending on their specific condition.
Advantages of Mitral Valve Repair Over Replacement
There are several advantages of mitral valve repair over replacement, including:
- Better survival rates
- Improved heart function
- Lower risk of stroke and infection
- No need for blood thinners after surgery
The cardiac surgeon will recommend repair over replacement whenever possible. However, replacement surgery may be the better option in some situations. It is also quicker and less complex to perform than repair surgery.
Life After Surgery
After surgery, patients typically experience reduced symptoms and an improved quality of life. Patients who undergo mitral valve replacement with a mechanical valve will need to take blood thinners to prevent blood clots.
Regular health check-ups are essential to ensure that the new or repaired valve is functioning properly. Patients may need cardiac rehabilitation to improve their health post-surgery. Additionally, a healthy lifestyle that includes regular exercise, a balanced diet, stress management, and avoiding smoking is crucial for long-term recovery.
