Mitral Valve Repair Surgery

Introduction

Mitral valve repair surgery is a procedure performed to fix problems with the mitral valve, one of the four heart valves that ensure proper blood flow through the heart. This surgery is primarily used to treat mitral valve prolapse, regurgitation (leakage), or stenosis (narrowing).

When is Mitral Valve Repair Needed?

Mitral valve repair surgery is considered when a patient has severe mitral valve disease leading to symptoms such as: - Shortness of breath, especially with exertion - Fatigue and weakness - Irregular heart rhythms (arrhythmias) - Fluid buildup in the lungs (pulmonary edema) - Heart failure symptoms

Types of Mitral Valve Repair Procedures

There are several techniques used for mitral valve repair, including: - Annuloplasty: Reinforcing the ring (annulus) around the valve to prevent leakage. - Leaflet Repair: Correcting any abnormal movements or floppiness of the valve leaflets. - Chordal Repair: Replacing or reinforcing the chordae tendineae, the structures that support the valve. - Minimally Invasive Techniques: Using robotic or endoscopic procedures for faster recovery and reduced risks.

Benefits of Mitral Valve Repair vs. Replacement

  • Preserves the natural valve: Maintaining native valve function is usually superior to replacement.
  • Reduces the need for lifelong blood thinners: Unlike mechanical valve replacement, repair eliminates the need for anticoagulation therapy.
  • Better long-term outcomes: Higher survival rates and lower risk of complications.

Recovery and Outlook

Patients undergoing mitral valve repair usually experience a good recovery. The timeline consists of: - Hospital Stay: Typically, 3-7 days, depending on the surgical approach. - Rehabilitation: Cardiac rehab may be recommended to improve recovery. - Full Recovery: Most patients return to normal activities within 6-12 weeks.

Conclusion

Mitral valve repair surgery is a highly effective treatment for certain mitral valve diseases. It offers advantages over valve replacement, resulting in improved long-term heart function and quality of life. Consultation with a cardiologist and a cardiac surgeon is essential to determine the best treatment strategy.

Source recommendations

1. American Heart Association/American College of Cardiology (AHA/ACC) Guidelines for the Management of Patients With Valvular Heart Disease

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923
  2. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/03/13/18/13/2024-acc-aha-clinical-performance-valvular
  3. https://pubmed.ncbi.nlm.nih.gov/33332149/
  4. https://www.jacc.org/doi/10.1016/j.jacc.2017.03.011
  5. https://pubmed.ncbi.nlm.nih.gov/24589852/

2. European Society of Cardiology (ESC) Guidelines for the Management of Valvular Heart Disease

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Valvular-Heart-Disease-Guidelines
  2. https://academic.oup.com/eurheartj/article/43/7/561/6358470
  3. https://pubmed.ncbi.nlm.nih.gov/34453165/
  4. https://academic.oup.com/eurheartj/article/38/36/2739/4095039
  5. https://eurointervention.pcronline.com/article/2021-esc-eacts-guidelines-for-the-management-of-valvular-heart-disease

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