In the treatment of mitral valve prolapse, what are your options with mitral valve surgery?
Treatment of mitral valve prolapse sometimes requires mitral valve surgery. In fact, surgical intervention may be necessary with any type of mitral valve disease, especially mitral valve regurgitation and mitral valve stenosis.
Surgery to correct problems with the mitral valve becomes a necessity when changes in the valve begin to cause major MVP symptoms and dysfunction. However, there are different types of surgery. Depending on one’s circumstances and condition, some types may be more appropriate. As a patient, you should know your options.
What are your mitral valve surgery options?
Invasive mitral valve repair surgery
During invasive surgical treatment of mitral valve prolapse, a cardiac surgeon opens the chest by making an incision down the center of the sternum (breastbone). This provides unhindered access to the heart, allowing the surgeon to repair the defective or damaged mitral valve and its structures.
Invasive mitral valve surgery, also called open mitral valve surgery, is the standard surgical method to repair an inefficient mitral valve. It is traditional open heart surgery, which is a major operation that typically requires spending time in intensive care after surgery and a lengthy hospital stay.
In general, open surgery is effective and offers a good prognosis. However, because it causes trauma to the body, many doctors and patients now opt for minimally invasive surgeries. These procedures normally translate to less pain, better healing, fewer complications, and a shorter recovery time.
Minimally invasive mitral valve repair surgery
Minimally invasive surgical treatment of mitral valve prolapse (mini MVR) is a lot less invasive. As with traditional mitral repair surgery, the surgeon repairs the affected mitral valve and its structures. But, he or she accesses the heart through smaller incisions and with no cut or a partial cut to the sternum.
There are different ways to perform minimally invasive mitral valve surgery. One approach is to make a small incision under the right pectoral, after which the surgeon operates through between the ribs. With endoscopic surgery, a special camera and tools are used through tiny holes cut into the chest.
Robotically assisted mitral valve repair surgery is another method. In this procedure, tiny incisions are also made in the chest, but the surgeon uses robotic arms and a computer to perform the surgery. Mitral valvuloplasty and MitraClip repair are two common percutaneous repair options.
Invasive mitral valve replacement surgery
Invasive mitral valve replacement, like invasive mitral valve repair surgery, involves opening the chest. The surgeon cuts the breastbone for surgical treatment of mitral valve prolapse, mitral regurgitation, or mitral stenosis. Only, during this procedure, the doctor replaces the valve, rather than repairing it.
Two types of valves are available with mitral valve replacement surgery, namely mechanical and biological valves. Mechanical valves are made from man-made materials. Biological valves are made from animal or human tissue. Patients may need a new valve if the original valve is not repairable.
Invasive mitral valve replacement surgery is the most common surgery for replacing prolapsing, regurgitant, and stenotic or infected valves. While this method provides the best access to the heart, it is riskier than minimally invasive replacement surgery. The wound can take months to heal.
Minimally invasive mitral valve replacement surgery
Repairing the original mitral valve is the preferred surgical treatment of mitral valve prolapse and mitral valve disease. Nevertheless, when the valve shows extensive calcification, infection, or damage, doctors may need to replace it. Then, minimally invasive replacement offers advantages.
The goals with minimally invasive mitral valve surgery are the same as with traditional surgery of the mitral valve: to access the heart and replace the valve if it cannot be repaired. In comparison with conventional surgery, though, minimally invasive can reduce recovery time significantly.
Also, because the surgeon accesses the valve through small chest incisions rather than a large cut in the sternum, the patient experiences less pain. In addition, patients have a lower risk of infection with minimally invasive mitral valve replacement surgery and there is less scarring.
Which surgical treatment of mitral valve prolapse is right for you?
The mitral valve surgery that is right for you will depend upon a variety of factors. These include your age, the condition of your valve and heart anatomy, and your overall health. Your heart care specialist will help you determine the most beneficial surgical approach based on your profile.
Doctors generally recommend the safest, least invasive method, but not all patients can undergo minimally invasive surgery. Patients with severe calcification of the mitral annulus, for example, may not be ideal candidates for mini MVR. Those with aortic valve disease may also not be suitable.
Furthermore, many hospitals do not offer minimally invasive mitral valve repair and minimally invasive mitral valve replacement as surgical treatment options. This is usually due to a lack of medical resources. Although, “mini mitral” procedures are becoming increasingly more common.
What else do you need to know about mitral valve surgery?
Surgical treatment of mitral valve prolapse, stenosis, and a leaky valve is normally effective, regardless of the approach. Minimally invasive procedures offer some advantages over traditional surgery, but outcomes are good with both open heart surgery and minimally invasive surgery.
During most procedures, specialists stop the heart temporarily and connect the patient to a heart/lung machine. Patients receive general anesthesia before the operation. In some cases, minimally invasive procedures convert to invasive surgery, depending on what the surgeon finds inside the body.
Minimally invasive surgery can take longer than open surgery. Before the surgery, you may have to stop smoking, taking medication, and eating and drinking for a while. Afterwards, you will receive drugs for chest pain. You may need to go on blood thinners if the surgeon replaced your mitral valve.