Many factors help determine the appropriate surgery for mitral valve treatment, including a patient’s age and general health, the extent of damage to the valves, the type of valve, and the patient’s preference. Many of these procedures can be done using minimally invasive heart surgery.
Surgical options include mitral valve repair or replacement. Valves can be repaired or replaced with traditional heart valve surgery or a minimally invasive heart valve surgical procedure. Heart valves may also be repaired by other procedures such as percutaneous balloon valvotomy.
Stenosis (valve narrowing) may be corrected by cutting, separating or reconstructing the valve leaflets, or other valve components, to widen the valve opening. If the diseased native heart valve cannot be repaired, the surgeon may choose to replace it. Heart valve replacement surgery involves removing the diseased valve and replacing it with a prosthetic valve by sewing it to the annulus of the natural valve. There are two main types of prosthetic heart valves. Tissue (bioprosthetic) valves are made primarily from animal tissue, for example, a pig’s aortic (porcine) valve or from bovine (cow) pericardium. Mechanical valves are created from man-made materials.
Regurgitation (valve leakage) may be corrected by replacing or shortening the supporting valve structures to allow the valve to close tightly, or by inserting a prosthetic ring, called an annuloplasty ring, to reshape a deformed valve. Valve flaps (leaflets) may also be modified to stop blood from flowing backwards. When the cords and muscles are the right length, the valve leaflet edges meet and eliminate the leak.
Annuloplasty describes surgical techniques performed on the valve’s annulus, the ring of tissue that supports the valve leaflets. Purse-string sutures are sewn around the ring to make the opening smaller, which helps the leaflets meet again when the valve closes. Sometimes when repairing the annulus (the frame of the valve) it is necessary to implant an annuloplasty ring to downsize an abnormally enlarged valve opening so the leaflets can come together properly or to provide reinforcement of the annulus. Annuloplasty rings are specially designed to help restore the annulus of the valve to its normal shape and size.
Surgery to treat ischemic mitral regurgitation involves revascularization of the heart alongside repair of the mitral valve. The surgery involves implantation of an artificial ring (annuloplasty ring) along with coronary artery bypass grafting (CABG). Coronary artery bypass grafting (CABG) is a type of surgery called revascularization, used to improve blood flow to the heart in patients with severe coronary artery disease (CAD). During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (goes around) the blocked portion of the coronary artery. This new passage routes oxygen-rich blood around the blockage to the heart muscle.
Ask your doctor about heart valve repair or replacement surgery. Both procedures are commonly used and highly effective in treating heart valve conditions. You may even be able to stop taking certain medications after surgery.