Mitral Regurgitation is one of the most critical native valve diseases, growing globally. Patients with symptoms, or poor tolerance requires surgical mitral valve repair treatment. This in fact is the advanced version of percutaneous cardiac therapy which expands from percutaneous coronary and peripheral intervention to percutaneous valve intervention.
It has been found the surgical Mitral valve repair is performed only in 50% of the cases. In many cases practising physicians, despite severe symptoms and severe mitral regurgitation, do not prescribe surgery. The reason is lack of expertise in performing the procedure.
Percutaneous Mitral Valve Repair can be performed in two different approaches:
First is edge-to-edge technique which forms a double mitral valve orifice to replicate the surgical intervention. This technique requires much care and attention during transseptal catheterisation. There needs to be extreme collaboration between the echocardiographist and interventionist as they need to catch the valve at the exact moment and location. The procedure, if performed by expert hands, can minimise the mitral regurgitation to mild level in two-third of the patients, and risk is comparatively low.
Second technique is Mitral Annuloplasty, which is performed with the help of a constraining device in coronary sinus which resides in the vicinity of mitral annulus. It requires some other procedure to combine annuloplasty during surgical interventions on the mitral valve. This procedure is rather simple than the previous one as it only involves a catheterisation of the coronary sinus. This procedure has also recorded good success rates (90%) and higher safety profiles (80%). Considerable reduction in the regurgitation is noted.
Mitral valve repair usage differ from person to person, depending upon his/her sex, age, and gravity of illness. This generally provides a ground to implement the applications of further repairing.
Pros and Cons/Complications
The biggest advantage of Mitral Valve Repair surgery is that it repairs the valve rather than replacing it. Other advantages include:
- Lower mortality ratio than that in replacement (1-2% in repair while 6-8% in replacement.)
- Lower risk of strokes or infection.
- Improved life style and longer survival.
- Normal life span after Mitral valve repair
- Mitral valve repair dispenses the need of life long use of blood-thinners which is a requirement after mechanical mitral valve replacement surgery.
However, the treatment is very complicated hence require expertise in the field and is currently available at selected hospitals only.
No common side effects, specific to mitral valve repair, have been noted so far. The techniques have been found quite effective and beneficial to the patients. Researches are going on and new findings are awaited with interest.
There are many factors that would decide the cost of Mitral Valve Repair surgery such as insurance coverage, pre-existing health, location of the facility, age and gender of the patient, and it also depends on the technique to be administered. The exact cost estimate should be obtained from the hospitals and consultants, as they may vary tremendously.
Generally, after a successful repair, a normal life style can be resumed gradually with due consultation from the physician. Precautionary guidelines will be advised by the doctor on the basis of age, sex, and physical ability of the patient.