Mitral valve repair is used to treat leakage or stenosis (narrowing) of the mitral valve. The mitral valve allows blood to flow into the heart's main pumping chamber, the left ventricle. When the mitral valve leaks, blood flows back into the lungs. To compensate, the ventricle must pump more blood with each contraction to produce the same output of blood throughout the body. The heart can usually operate with this extra volume of blood for a period of time, but it eventually begins to fail producing symptoms of shortness of breath or fatigue.
It is clear that repair of mitral valve is indicated for symptomatic patients with moderate to severe mitral insufficiency. Medical literature now suggests that even patients without symptoms may benefit from the procedure. Treating the patient early while healthy makes for a safer procedure and gets them back that much quicker to enjoying their life.
The majority of patients in need of a mitral valve procedure are considered a candidate for valve repair. Not all patients ultimately are eligible for repair, but that is never known for certain until further evaluation with the a transesophageal echocardiogram (TEE), an echocardiogram that provides a detailed anatomy of the heart and visual inspection of the mitral valve are completed.
For those patients whose valve is not a suitable for repair, replacement with a man made valve is an option. The advantages of repair over replacement include a lower risk of stroke, a longer life expectancy and improved function of the heart. Also with mitral valve repair, blood-thinning medications are not required. Patients with mitral valve replacement may have a life-long requirement for blood thinners, which puts them at risk for bleeding complications.
As early as six or seven years ago, many patients in need of mitral valve work were not sent to surgery but were treated with medications. Today, many physicians are referring their patients earlier for surgery particularly since it may prevent irreversible damage to the heart.