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To treat mitral valve regurgitation surgically, the options are to repair or replace the mitral valve.
Repair of the heart valve may be recommended if it is likely that the valve can be repaired and that the repair will last a long time.
Valve replacement may be recommended if your mitral valve is seriously damaged and cannot be repaired.
The decision about whether to repair or replace a valve is based on many things, including your general health, the condition of the damaged valve, the presence of other health conditions, and the expected benefits of surgery. In some cases, the decision clearly may be in favor of repair or in favor of replacement.
Repair for mitral valve regurgitation may be recommended based on a few things. These include whether the valve can be repaired successfully.
Repair is more successful if there is not a lot of damage to certain areas of the mitral valve flaps (leaflets) or to the tough fibers that control movement of the mitral valve leaflets (chordae tendineae).
Mitral valve repair is usually preferred if your valve is suitable for reconstruction and the surgeon has the appropriate level of experience and surgical skill.
The advantages of mitral valve repair include the following:
Examples of serious damage or complicated conditions that might lead to mitral valve replacement include:
Replacement surgery is usually preferred if you have a hard, calcified mitral valve ring (annulus) or widespread damage to the valve and surrounding tissue.
The disadvantages of mitral valve replacement include the following:
If you choose mitral valve replacement, your surgeon will preserve as much of the valve as possible. Doing so provides a greater chance of success after surgery. Keeping the valve's base intact reduces the amount of foreign structures to which the heart must grow accustomed after replacement surgery.
A transcatheter procedure is a new way to repair a mitral valve. It does not require open-heart surgery. It is a minimally invasive procedure. A doctor uses catheters in blood vessels to insert a device in the valve. The device helps keep blood from leaking backward. This may relieve symptoms and improve quality of life. This procedure is available in a small number of hospitals. And it is not right for everyone. It might be done for a person who can't have surgery or for a person who has a high risk of serious problems from surgery.footnote 1
CitationsA percutaneous device (MitraClip) for mitral regurgitation (2013). Medical Letter on Drugs and Therapeutics, 55(1432): 103.Other Works ConsultedNishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.
ByHealthwise StaffPrimary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, ElectrophysiologyMartin J. Gabica, MD - Family MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerJohn A. McPherson, MD, FACC, FSCAI - Cardiology
Current as ofOctober 5, 2017
Current as of: October 5, 2017
Author: Healthwise Staff
Medical Review: Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & Martin J. Gabica, MD - Family Medicine & Adam Husney, MD - Family Medicine & John A. McPherson, MD, FACC, FSCAI - Cardiology
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