What is Mitral Valve Repair?

Mitral valve repair, as the name suggests is the name given to surgical procedure for repairing the damaged mitral valve. It is performed in case of any malfunctioning of the valve resulting from either narrowing of the valve(stenosis) or leaking of the valve(regurgitation). Mitral Valve repair is used most commonly in cases involving a leaking valve and is highly preferred by cardiac surgeons over valve replacement as a better option.

The mitral valve is the valve separating the two left chambers of the heart viz. the left atrium and the left ventricle and it’s main function is to prevent the backflow of blood from the ventricle to the atrium. The proper functioning of the mitral valve is of utmost importance to the human body and whenever it malfunctions it should be repaired. For instance when the valve is leaky as in the case of Mitral Regurgitation the blood flows back from the left ventricle back to the atrium and from there back towards the lungs. Initially the heart is able to cope up with the additional load but in the long term this can lead to severe complications.

Mitral Valve Repair Surgery

A review of the medical history of the patient is first done before commencing the surgery and chest x ray and certain other tests are conducted to determine if the patient is at any risk during the surgical procedure. The patient is given an anesthetic and put to sleep temporarily. The surgeon then makes and incision on the chest and exposes the valve and makes another incision and exposes the mitral valve. The patient is also put on cardiopulmonary Bypass or a Heart-lung machine which basically performs the functions of the heart and lungs i.e. the blood returning to the heart is removed and oxygenated in the heart-lung machine and returned to the aorta, thus eliminating the heart while still providing the body with oxygenated blood.

There are two main methods for mitral valve repair namely, annuloplasty and balloon valvuloplasty. In annuloplasty an artificial ring is placed around the annulus of the valve. This ring reinforces the annulus and restores the valve to its normal shape and size. Balloon valvuloplasty is performed using a catheter, i.e. a very thin flexible tube which can be inserted into the body, with a balloon at the end. The balloon is put inside the valve and is expanded thus stretching the valve and bringing it back to its normal size.

After the surgical procedure the patient is removed from the cardiopulmonary bypass and the chest incision is closed. An echocardiogram is also done after the surgery to evaluate if it has been effective. If valve disorder still persists a revision of the procedure is done since the surgeon is unable to determine how the blood flow will be initially the patient being put on bypass.

Mitral valve replacement is also highly preferred compared to valve replacement because it lowers risk of further complications, improves long term survival, restores the normal heart function better and eliminates the need to take blood thinners on a long term basis.