Overview of Mitral Valve Repair/Replacement

Mitral valve repair/replacement is a treatment for mitral valve regurgitation. When the mitral valve becomes insufficient or incompetent, blood flow leaks back through the valve. This puts extra strain on the heart, as it must pump additional blood during each heartbeat.

Whenever possible, physicians strive to perform mitral valve repair rather than replacement. Valve repair operations reconstruct the patient's own valve to improve the function of both the valve and the heart. Many patients require heart surgery to repair the mitral valve, though less invasive options may be suitable for certain patients.

Traditional mitral valve repair: The mitral valve is formed like a small parachute. The valve is repaired by placing a supportive ring around the rim, or annulus, of the valve. Small portions of the valve leaflets may be removed if there is extra valve tissue. Synthetic cords, or neochordae, are fashioned from thin, flexible sutures to provide additional strength and support to the valve leaflets.

Minithoracotamy: is a less invasive surgical option available for certain patients. Minithoracotomy requires a small incision in the right chest in order to perform the valve repair. This procedure reduces the amount of discomfort and allows patients to return to normal activity more rapidly.

Catheter-based options: Patients with worsening mitral valve regurigitation whose surgical risk is too high may qualify for a catheter-based therapy called MitraClip. Doctors place the MitraClip device using a catheter (a small tube). The catheter is inserted in a vessel in the leg and does not require a chest incision, use of a heart-lung machine, or stopping of the heart.

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