Choose the content to read
- Why mitral valve repair?
- What disease does mitral valve repair treat?
- What is the diagnosis before mitral valve repair?
- What is the mitral valve repair procedure?
- What are the benefits of mitral valve repair?
- Mitral valve repair at MedPark Hospital
Mitral Valve Repair
Mitral valve repair is a surgical procedure for correcting mitral valve leakage or narrowing involving surgically repairing and sewing the edges of mitral valve leaflets and inserting in an annuloplasty ring to correct the abnormal opening and closing of mitral valve leaflets that partition the two left heart’s chambers, the left atrium and left ventricle, to restore normal functions. Mitral valve repair corrects mitral valve regurgitation, mitral valve stenosis, or mitral valve prolapse, the primary cause of easy fatigue, inability to lie flat, shortness of breath, chest pain, and fainting. Mitral valve repair corrects incomplete mitral valve closure, prevents blood from flowing backward, and effectively treats heart failure, preventing heart attack and premature death. The surgery has few complications and is regarded as a very safe procedure.
Why mitral valve repair?
Mitral valve regurgitation or stenosis due to congenital malformation in young children, rheumatic heart valve disease (RHVD) in older children, or age-related heart valve degeneration in adults. If left untreated, it will cause the mitral valve to not completely open or close; the heart has to work harder to pump blood, resulting in coronary artery stenosis and a weak heart muscle (cardiomyopathy), resulting in left ventricular hypertrophy (LVH), mitral annular calcification, pulmonary edema, chest pain, and orthopnea. This can eventually result in heart failure and death.
Mitral valve repair is a surgical procedure to repair a prolapse, sagging, or torn heart valve, using the patient's pericardium as the main tissue to replace the deteriorated part and inserting an annuloplasty ring to tighten and reinforce it into the anatomical structure of the heart valve leaflets, without the need for a heart valve replacement with a mechanical heart valve or taking life-long blood-thinning medications. Mitral valve repair offers excellent treatment outcomes, has minimum side effects, and enables patients to resume their normal lives quickly.
What disease does mitral valve repair treat?
Mitral valve repair can effectively treat the following diseases:
- Mitral valve regurgitation
- Mitral valve stenosis
- Mitral valve prolapse
Symptoms of heart valve regurgitation?
- Easily tired even when sitting still, lethargic, exhausted after exertion
- Shortness of breath, difficulty breathing, dyspnea
- Inability to lie flat (orthopnea)
- Chest pain
- Heart palpitations, irregular heartbeat, heart murmurs
- Dizziness, lightheadedness, fainting
- Swelling of the abdomen, legs, and feet
- Coughing, bloody sputum
- Blood congestion in the lungs, pulmonary edema
What is the diagnosis before mitral valve repair?
The cardiologist will diagnose cardiovascular disease by inquiring about the patient's medical history, including symptoms, duration of symptoms, underlying diseases, medications, and daily life effects. Then, performing additional specific exams, including a physical examination and medical imaging examinations, to assess the physical condition, pathology, and severity of the disease, as follows:
- Echocardiogram: An ultrasound examination of the heart, using high-frequency sound waves to create images of the 4 heart chambers and heart valves to assess abnormalities in heart function, examine heart valves, the contraction and relaxation of the heart muscle, the electrocardiogram, and the heart rate.
- Electrocardiogram (EKG/ECG) detects abnormal heart electrical signals, checks the regularity of the heart rate, and examines the abnormal contraction and relaxation of the heart rhythm, including the detection of cardiovascular diseases such as myocardial ischemic, mitral valve disease, or heart arrhythmias.
- Heart CT scan examines the entire heart structure, including the heart muscle, heart wall (septum), heart valves, blood circulation, calcium buildup in the coronary arteries, thickened coronary artery walls, enlarged heart, calcification of the heart valves, heart valve fibrosis, and heart valve regurgitation, stenosis, or prolapse.
What is the mitral valve repair procedure?
Mitral valve repair at MedPark Hospital adopts the gold standard in surgery, prioritizing safety and treatment success outcomes to achieve the treatment goal of restoring normal heart valve functions, curing the heart valve regurgitation, and restoring normal functioning heart and blood vessels, allowing patients to regain healthy physical health and live a long life
Preparation for mitral valve repair
- Stop taking blood thinners such as aspirin, Naproxen, Plavix, or NSAIDS at least 1 week before surgery. Those with underlying diseases or a history of drug allergies must notify the doctor in advance.
- Quit smoking at least 2 weeks before surgery, as cigarette smoke can slow sternal bone healing and increase the risk of complications.
- Refrain from eating or drinking at least 6 hours before the surgery and stop drinking alcohol at least 24 hours before the surgery.
Intraoperation of mitral valve repair
- The anesthesiologist administers general anesthesia to sedate the sensations before performing an open-heart surgery using the heart-lung machine (on-pump CABG) to temporarily pump blood to supply various parts of the body instead of the heart.
- The cardiac surgeon makes an incision in the left ventricle to trim, reshape, and rebuild a prolapsed, sagging, or leaky mitral valve. If the mitral valve is severely damaged, the cardiac surgeon will consider harvesting pericardial tissue from another part to replace it.
- The cardiac surgeon inserts an annuloplasty ring and sews it (annulus) around the valve meticulously, tightly, and securely reinforced to the anatomical structure of the heart valve leaflets with the appropriate tightness and relaxation, enabling them to fully open and completely close without backflows or leakage.
- Once the mitral valve repair is complete, the cardiac surgeon will inspect the surgical site, dial down, and gradually turn off the heart-lung machine. Then, the heart's functions will be examined using a transesophageal echocardiogram (TEE).
- When the inspection confirms the mitral valve is functioning properly, the cardiac surgeon will stitch the incisions both in the left ventricle and chest. Typically, mitral valve repair takes approximately 5-7 hours.
Postoperative care of mitral valve repair
- The cardiac surgeon and clinical staff will admit the patient to the ICU for 1-2 days to assess symptoms and monitor vital signs, depending on each individual's physical recovery and safety.
- The doctor will administer intravenous pain medication to alleviate the pain and take measures to prevent complications, such as blood clots.
- The patient will stay in the hospital for 3-4 days. The doctor will assess the symptoms periodically. If no abnormalities are found, they will allow the patient to return home.
What is the mitral valve repair aftercare?
- Take medication as prescribed by the doctor continuously. If you experience pain, nausea, vomiting, or fever, seek medical attention at the hospital right away.
- Avoid eating foods that are very salty, spicy, or greasy to prevent fluid retention (edema) in bodily organs, including the lungs, arms, or legs.
- Avoid lifting heavy objects, strenuous exercise, or forceful activities for 8–12 weeks, depending on the doctor's discretion.
- Get enough sleep, eat nutritious food, and exercise appropriately as advised by the doctor.
What is the recovery time of mitral valve repair?
Typically, the recovery period for mitral valve repair is 4–8 weeks, while bone healing takes 4–6 weeks. The patient can assist themselves in 4–6 weeks, drive in 8–10 weeks, and perform daily activities in 8–12 weeks, depending on their age and physical strength.
What is the complication of heart valve repair?
Common complications from heart valve repair include bleeding, blood clots, or infection at the surgical site. Severe complications from heart valve repair include heart arrhythmia, lung infections, or heart failure as a result of long-standing severe damage to the heart valve and inordinate delay in seeking medical attention until the symptoms are severe. The doctor will then consider appropriate treatment options for each individual.
What is the success of mitral valve repair?
Mitral valve repair has a postoperative success rate of 80–90%, depending on the extent of damage to the mitral valve before surgery. Approximately 90% of patients do not require surgery within 20 years. Overall, if there is no serious complication, mitral valve repair has a high survival rate with a mortality rate of only 1–2%.
What are the benefits of mitral valve repair?
- Maintain normal cardiovascular function, including the heart and blood vessels.
- Treat chest pain, fatigue, and shortness of breath at the source
- Reduce the risk of heart attack, heart failure, and stroke.
- Low complications; no need for lifelong blood thinners.
- High survival rate after surgery, increased life expectancy.
- Eliminate concerns about fainting, collapsing, and losing consciousness; improve quality of life
- Better treatment outcomes than heart valve replacement with metal valves or biological tissue.
- Reduces the risk of complications for the elderly, those with underlying diseases, or vulnerability
Mitral valve repair at MedPark Hospital
Cardiology Center, MedPark Hospital, Bangkok, Thailand, led by a team of cardiovascular surgeons at the professor level with extensive experience both domestically and internationally, is ready to diagnose and treat cardiovascular diseases including heart valve regurgitation, heart valve stenosis, or complex heart valve prolapse with heart valve repair surgeries and other treatment options using state-of-the-art medical technology and equipment with JCI standard hybrid operating theaters. Combining with advanced surgical techniques of skilled cardiac surgeons enables fast, accurate, and safe treatment outcomes, resulting in the most treatment efficacy. Integrating with a cardiac rehabilitation program supervised by a multidisciplinary team who are ready to provide consistent postoperative care, ensuring patients are free from complications, recover quickly, have good physical health, and live a long life.
