Mitral valve repair is a surgical procedure to treat diseases of the mitral valve, which is located between the two left chambers of the heart (left atrium and left ventricle).
There are several types of mitral valve diseases:
Mitral valve regurgitation: The flaps or leaflets of the mitral valve don't close tightly, cause leakage of blood back into the left atrium of the heart. A condition called mitral valve prolapse, which involves bulging back of the valve leaflets, is commonly the reason behind this.
Another disease is mitral valve stenosis. In this, the valve leaflets become thick or stiff, and might even fuse together. This narrows the valve opening and results in reduced flow of blood through the valve.
Treatment for mitral valve disease includes mitral valve repair and mitral valve replacement. The choice of treatments depends on the severity of the condition. There are various different methods to perform surgical repair or replacement of mitral valves, including open-heart surgery, catheterization or minimally invasive heart surgery.
Mitral valve repair is considered to be the best and effective treatment option for almost all patients with a leaking mitral valve (regurgitant) and for many with narrowed mitral valve (stenotic) condition.
Many studies confirm the excellent long-term clinical results of mitral valve repair. It is also reported that suitable repair technique with good facilities for immediate postoperative care are also determinants of late failures, requiring a secondary mitral valve surgery.
Mitral valve repair, in comparison to mitral valve replacement, has shown better long-term survival rates, improved preservation of heart function, reduced risk of complications, and usually eliminates the dependency on blood thinners (anticoagulants) for long-term use. These factors along with the recent improvement in long-term durability of valve repair are the reasons most cardiac surgeons in India are committed to mitral valve repair, whenever possible. People from all over the world travel to India to avail best cardiology treatment at highly reasonable prices. The low cost of mitral valve repair in India with high quality patient care is the prime reason patients prefer to choose the country.
About 95% of patients after mitral valve repair remain free from need of reoperation for 10 years. Similar statistics have been reported at 20 years. Therefore a successful mitral valve repair significantly limits the chances of reoperation. Cardiologists recommend annual echocardiogram tests to assess valve function in patients who underwent mitral valve repair. Also the patients, after valve surgery must take precautions to prevent risk of infections, such as endocarditis (an infection of the heart valve).
The goal of the surgery for mitral valve repair involves:
- Patching the holes in the valve
- Reconnecting the leaflets of valve
- Removing excess valve tissue to allow them to close tightly
- Replacing cords supporting the valve to repair the structural valve support
- Separating valve leaflets that have fused
It may involve tightening or reinforcing the ring around the valve, called annulus, during a procedure called an annuloplasty.
Mitral valve repair is also performed using a long, thin tube called catheter along with clips or other devices.
In a catheter procedure, the doctor inserts a catheter with a clip attached to it through an artery in the groin. The catheter is then guided to the mitral valve and the clip is used to reshape the mitral valve. This procedure is usually considered for people who suffer from severe symptoms of mitral valve regurgitation and aren't suitable for surgery or those who have a high risk of surgical complications.
The catheter procedure can also be used to insert a device to plug the leaks in a leaking replacement mitral valve, which was previously implanted during mitral valve replacement surgery.
A stenotic mitral valve with a narrowed opening can also be treated using the catheter procedure, known as balloon valvuloplasty. During this procedure, the cardiac surgeon inserts a catheter with a balloon attached to the tip through an artery in the arm or groin. The catheter is then guided towards the mitral valve. The heart specialist then inflates the balloon to expand the opening of the mitral valve. Then the balloon is deflated, and the catheter along with the balloon are removed.
The mitral valve repair surgery enables you to return to your normal daily activities, such as working, driving and exercise. Your cardiologist will evaluate the heart functions to determine when you can return to everyday activities. Certain medications will be prescribed depending on your condition.
Regular follow-up appointments with the doctor are scheduled to keep on your heart and valve functions. Several tests are also recommended to evaluate and monitor the heart condition.
The doctor will provide you specific instructions that must be followed and incorporated for a healthy lifestyle. These may include physical activities, a healthy diet, avoiding smoking/tobacco use, and stress management .
It is also recommended to participate in cardiac rehabilitation program to help you recover after heart surgery and improve your overall health.