Mitral valve repair is a procedure in which the mitral valve is reconstructed or repaired. This procedure is cardiac surgery that is performed by cardiac surgeons. When the mitral valve does not work properly, either because of mitral valve stenosis or narrowing of the valve or because of regurgitation or leakage, it does not work efficiently. Blood has been pumped into the left atrium of the heart from the pulmonary veins and flows from there to the left ventricle. When the mitral valve does not work properly, the oxygen rich blood leaks back into the atrium and pumps over and over again.
The seriousness of this disease depends on how great the leakage is. Some people can live a fairly normal life without having the valve repaired, but others need immediate surgery to fix the problem. Most of the time, this valve disease is found when a doctor hears a murmur while checking the patient’s heart. Mitral valve disease often occurs with age, but a person may be born with it. It can also result from endocarditis, which is a bacterial infection of the heart that damages this valve. It can also result from rheumatic fever. Symptoms of this problem include fatigue, cough, or palpitations, but there may not be any symptoms at all. It is estimated that as many as one out of ten people has this valve problem, but is not aware that they have it.
Repair of the mitral valve is usually required if the problem greatly affects a patient’s life. Another time when it is necessary is when a patient is experiencing heart failure. Replacing a defective valve can protect the heart from becoming enlarged and causing other problems. Cardiologists can repair the valve by sewing the loose flaps together, but it is sometimes necessary to replace the valve. This can be done with a completely artificial valve or one that is part artificial and partially from a pig’s heart. Repair of the patient’s own mitral valve is the most desirable treatment if surgery is needed and if the valve has not been damaged beyond repair.
The disadvantage of having an artificial valve is that it will only last for 10 to 15 years, and at that point surgery to insert another new valve will be necessary. Patients are often older and not able to withstand the procedure when they are in their seventies or eighties. Patients with artificial valves also tend to develop blood clots in the heart, so it is necessary for them to take blood thinners for the span of their life. This can cause serious bleeding and other side effects and should be avoided if possible.
Some hospitals and heart centers focus on mitral valve repair. Cardiologists who are experienced and skilled in this surgery are in high demand. They repair leaking mitral valves in several ways. If the flaps or leaflets of the valve are in good shape, the surgeons are able to sew them together. The valve heals and is then able to function properly. If more extensive repair of the valve is necessary, a ring is placed around the valve for additional support. The ring helps the valve return to its normal size and shape.
Recent studies have shown that it is often better to have mitral valve repair before a patient develops severe problems and heart failure from the valve disorder. Fixing the valve while the patient is not experiencing severe dysfunction of it is often safer for patients. If minimally invasive surgery can be used, recover time takes only days and a patient can return to normal activities in a short time. Open heart surgery takes six to eight weeks of recovery and can be difficult and painful. The outcome after recovery enables many patients to live a normal life that they would not been able to do without mitral valve repair.