Featured Article

Mitral Valve Treatment and Repair

Providers: Verrier, Edward D. Last Updated: Wednesday, March 21, 2007

Most patients with mitral-valve abnormalities are candidates for surgical repair. In about 85 percent of cases, the valve can be repaired instead of replaced. The surgeon can repair the valve tissue and also modify blood vessels to increase blood supply to the valve. In cases where the valve is too damaged to be repaired, patients have two options for replacement. In one type of replacement, the surgeon implants a mechanical valve, usually made from carbon fiber or titanium. This valve is very durable, but the patient must take blood-thinning medication for the rest of his life. (Those who cannot take the medication reliably should avoid this option.) The second replacement option is a bio-prosthetic valve. It is usually constructed from the sac lining of a cow’s heart (bovine pericardium) or is an actual mitral valve from a pig (porcine valve). Unless the patient has a heart-rhythm disturbance, this valve requires no blood-thinning medications. However, it will wear out and must be surgically replaced every 10-20 years. No surgical option is right for everyone; a patient should discuss his case with his doctor.

Both repair and replacement require an open-heart surgery that takes place under general anesthesia. As with all open-heart procedures, the surgeon enters the chest cavity by cutting the breastbone. He stops the patient’s heart after the patient is placed on a heart-lung machine. He then makes an incision in the left atrium to access the mitral valve. The operation takes three to four hours, not counting anesthesia and surgical prep. After surgery, the patient remains in intensive care for one to two days and is usually discharged after six to eight days. The breastbone takes six weeks to heal, and the patient can usually return to work after four to eight weeks.
View Full Article »