Mitral Valve Repair

A mitral valve repair is a surgical procedure that aims to improve blood leakage in the heart’s mitral valve. This valve is located between the left atrium and the left ventricle and is made of two triangular-shaped flaps of tissue called leaflets. These leaflets are attached to the heart through a ring of connective tissue called the annulus.

The mitral valve controls blood flow between the left atrium and left ventricle and regulates the speed at which blood leaves these chambers through coordinated opening and closing. When the leaflets cannot properly open and allow for blood flow into the ventricle, a range of problems can occur.

Mitral Valve Diseases

There are two main mitral valve diseases: mitral valve regurgitation and mitral valve stenosis.

Mitral Valve Regurgitation

Mitral valve regurgitation occurs when blood flows backward into the left atrium during ventricular contraction due to a defect with the leaflets of the mitral valve. When this happens, heart function can decrease and lead to a series of other complications. Medications can moderate the problem in those with mild to moderate mitral valve regurgitation, but in patients with severe mitral regurgitation, an intervention is often needed.

The most common type of mitral valve regurgitation is caused by a condition in which the valve leaflets are elongated (floppy) or unsupported. If cord-like structures are weakened or torn, they may not be able to fully maintain closure of the leaflets and result in a significant valve leakage.

Mitral Valve Stenosis

Mitral valve stenosis is a condition in which the valve leaflets become thick and stiff or merged together. As a result, the valve narrows and cannot open properly, preventing blood from flowing from the left atrium to the left ventricle. Over time, the narrowing of the valve can lead to excess pressure on the heart and a buildup of fluid in your lungs.

Symptoms of Mitral Valve Disease

Individuals affected with mitral valve disease may not experience symptoms for many years. When symptoms do arise, they often include:

• Shortness of breath
• Abnormal heart sound
• Swelling in ankles or legs
• Lightheadedness
• Chest pain
• Fatigue
• Irregular heartbeat

Mitral Valve Repair Procedure

To mend the damage done to the mitral valve, repairs can be performed surgically in the following ways:

• Open-heart surgery
• Minimally invasive heart surgery
• Robotic-assisted heart surgery
• Transcatheter procedure

Most procedures will last about three to four hours with the patient receiving general anesthesia. Depending on the procedure, the severity of the disease, and how your mitral valves are damaged, your mitral valve repair may involve replacing the cords surrounding the mitral valve, removing the excess tissue from the valve, reconnecting the valve leaflets, or separating leaflets that have fused together.

Risks associated with a mitral valve repair are rare but may include:

• Heart attack
• Stroke
• Bleeding
• Valve dysfunction
• Infection
• Blood clots

Patients who receive a mitral valve repair will need to remain in the hospital for three to five days to monitor their condition and watch for signs of complications. Often, you may need to complete low-intensity physical activity and breathing exercises to recover. Mitral valve repairs tend to reduce heart disease symptoms and improve quality of life. However, following a healthy lifestyle after surgery will play a significant role in recovery. Following a mitral valve repair, a short period of anticoagulation may be required.