Mitral Valve Repair or Mitral Valve Replacement

In coordination with our entire heart team, UT Southwestern Medical Center’s experienced interventional cardiologists and cardiothoracic surgeons perform surgery and catheter-based procedures to expertly repair or replace the mitral valve to treat mitral valve prolapse, mitral valve stenosis, and other mitral valve conditions.

Our Heart and Vascular Center is one of the nation’s leading programs, offering a variety of approaches to mitral valve repair and replacement, including using minimally invasive surgery and catheter-based treatments.

What Are Mitral Valve Disorders?

The mitral valve is a two-leaflet valve between two chambers of the heart – the left atrium and the left ventricle. When the mitral valve doesn’t close as it should, blood can leak backward into the left atrium and even into the lungs, causing serious breathing problems for the patient.

For patients with severe mitral valve prolapse, mitral valve stenosis, or other mitral valve disease, a mitral valve repair or replacement is a surgical treatment. The surgeon can either repair the mitral valve or replace it with a prosthetic valve.

Prosthetic valves can be mechanical or biological. Mechanical valves are made of metal, last longer, and require anticoagulation. Biological valves are made of human or animal tissue, require less anticoagulation, and have a shorter life span.

UT Southwestern’s heart surgeons are experts in minimally invasive approaches to valve surgery. We’ve performed more of these procedures than others in North Texas, and UT Southwestern is leading the advancement of additional treatments such as the MitraClip and transcatheter mitral valve replacement procedure in patients who might have a previous valve replacement that has failed.

UT Southwestern also offers a dedicated Cardiac Rehabilitation Program. Cardiac rehabilitation is a critical component of recovery and can prevent future heart disease.

What Procedures Are Used for Mitral Valve Disorders?

Minimally Invasive Surgery

Whenever possible, we recommend minimally invasive valve surgery. When using a minimally invasive approach, UT Southwestern’s heart valve experts make small incisions (about 2 inches) between the ribs to access the heart. The result is faster recovery and less pain. Instead of a six-week recovery, our patients generally need about 10 days to recover from surgery when performed using minimally invasive techniques.

Patients with mitral regurgitation who are too old or sick for open surgery might be treated with mitral valve transcatheter edge-to-edge repair (using the MitraClip or PASCAL devices). Going through the skin (percutaneous), we clip together the two leaflets of the mitral valve to minimize the leaking.

Open-Heart Surgery

When open-heart surgery is the best option for a patient, our team has the experience patients can trust. We perform more than 600 procedures a year.

In open-heart mitral valve repair or replacement, the surgeon begins by making an incision in the midline of the chest and spreading the chest cavity to reach the heart. The patient is then placed on a cardiopulmonary bypass machine – which pumps blood to the body, bypassing the heart except for the coronary arteries – while the heart is stopped temporarily.

An incision is made in the left atrium of the heart to access the mitral valve, and it is then either repaired or replaced.

If the valve is replaced, the mitral valve leaflets are taken out before the prosthetic valve is placed. The heart is then closed and restarted, allowing blood to flow back through the heart.

Pacing wires are placed on the heart in case there are any irregular heart rhythms during the recovery period in the hospital, and the chest is closed with wires and stitches.

After surgery, patients are taken to the intensive care unit and monitored. Pain is likely, and pain medication is given as appropriate. Patients might also be on a respirator for up to a day after the surgery.

The length of the hospital stay depends on how quickly the patient is able to recover and perform some physical activity.

What Clinical Trials Are Available for Mitral Valve Disorders?

As one of the nation’s top academic medical centers, UT Southwestern offers a number of clinical trials aimed at improving the outcomes of patients with cardiovascular disease.

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials can receive treatments years before they are available to the public.