MITRAL VALVE SURGERY: PROCEDURE & BENEFITS

Mitral valve replacement is an open-heart surgical procedure done for the replacement of diseased mitral valve with either a bioprosthetic heart valve or a mechanical valve. Mitral valve replacement may be required for mitral regurgitation (a leaky mitral valve), mitral stenosis (tight mitral valve), or both. The reasons for mitral valve disease are the infection, calcification, inherited collagen disease or some other cause. Before choosing prosthetic heart valve, many factors are needed to be considered since, the choice of heart valve will affect the patient's age, medical condition, preferences with medication, and lifestyle. There are two types of artificial heart valves- mechanical valves and bioprosthetic tissue valves. Mechanical valves can last  a lifetime since they are made from metal and pyrolytic carbon. But the problem for the patients with mechanical valves is that they must take blood-thinning medications to prevent blood clotting. Even though in the case of patients with biological valves (tissue valves) can avoid blood thinners, these biological valves will last only for 10 to 15 years and must be replaced due to wear and tear. Hence biological valve may not be a concern for aged patients, due to the need for reoperation.

Procedures followed during a surgery

The patient will receive a general anesthesia. The incision is often created somewhat horizontally below the left breast, or vertically through the breastbone. When the heart is exposed, cannulae are placed to reroute blood to a heart-lung machine for cardiopulmonary bypass. An incision is created within the left atrium of the heart to show the left atrioventricular valve (mitral valve). The valve is then replaced with either a biological or mechanical valve. The left atrium is then closed, and therefore, the patient weaned from cardiopulmonary bypass. After surgery patients are usually taken to a medical care unit (ICU). Mitral valve surgery can now also be performed robotically. With the development of minimally invasive techniques such as TAVR, a valve replacement can be performed without the need for open heart surgery.

Benefits of mitral valve replacement surgery

• ·        Better quality of life
• ·        Prolonged life
• ·        Reduced heart symptoms

In the case of minimally damaged valves, mitral valves can be repaired instead of replacing it. The advantages for mitral valve repair are given below

• ·        Lower surgical mortality
• ·        Lower risk of stroke
• ·        Lower rate of endocardial infection
• ·        Improved long-term survival.
• ·        After mitral valve repair, blood thinners are not required