Guide to Mitral Valve Repair & Replacement

What Is Mitral Valve Repair?

Mitral valve repair is surgery that fixes a damaged mitral valve without removing it. The mitral valve consists of two triangular-shaped flaps of tissue called leaflets. The leaflets of the mitral valve connect to the heart muscle through a ring called the annulus. Cardiac surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons can also repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring around the valve (annulus). This is called an annuloplasty. It's important to have an experienced surgeon perform mitral valve repair.

Advantages of mitral valve repair include better early and late survival, improved lifestyle, better preservation of heart function, lower risk of stroke and infection (endocarditis), and no need for blood thinners (anticoagulation).

Mitral valve repair can be performed through traditional open-heart surgery (using an incision in the middle of the chest) or, in some cases, through smaller incisions called a minimally invasive approach. Some of these procedures may be robotically-assisted for further precision.

What Are the Risks of Mitral Valve Repair?

For people without symptoms having mitral valve repair, the operative risk is approximately 1 in 1000. Risk in symptomatic people is well under 1%. The presence of coronary artery disease or other conditions that require surgical treatment will affect the overall risk.

How Long Will Mitral Valve Repair Last?

Most people will not need a follow up operation after mitral valve repair. 95% of patients are free of reoperation at 10 years, and this statistic is similar at 20 years. An echocardiogram is suggested yearly to assess valve function.

Is Mitral Valve Replacement the Primary Treatment for Mitral Valve Regurgitation?

No, valve replacement is done only when valve repair is not possible.

What is Mitral Valve Replacement?

In mitral valve replacement surgery, the damaged mitral valve is replaced by an artificial (prosthetic) valve. The two types of artificial valves are mechanical valves and tissue valves. The type of valve replacement chosen depends largely on the severity of the condition and the overall health of the patient.

Like mitral valve repair, mitral valve replacement can be performed as a traditional, open surgery or through minimally invasive approaches, and surgery may be performed with robotic assistance.

When Does Mitral Valve Replacement Get Performed Instead of Mitral Valve Repair?

Mitral valve replacement may be recommended if a person’s valve is ballooning extensively, if there is severe calcification of the valve, if there is prolapse (bulging) in an unusual location, or if the valve has been damaged by endocarditis (an infection of the heart valve).

When deciding whether to repair or replace a mitral valve, a cardiac surgeon will consider many factors including overall health, other health conditions that may be present, the condition of the existing valve, and the likely benefits of surgery.

How Long Will It Take to Feel Well After Mitral Valve Surgery?

People will typically feel better as soon as their valve is repaired. It takes about two to three weeks for most people to feel well, although some healing and recovery may still continue in the following weeks and months.

If I Need Mitral Valve Repair or Replacement, What Are My Next Steps?

If you’ve been told by a cardiologist that you may need mitral valve repair or replacement, your next step should be to get an evaluation or second opinion from a cardiac surgeon. Our surgeons can help you decide if a mitral valve procedure is necessary for you, and if so, which type of procedure would be best.

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Next Steps

If you have heart disease and need help, we’re here for you. To get started today, call (212) 305-2633 or use our appointment request form.

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