Lynn Huffman, M.D. Answers Questions On: Mitral Valve Repair
When do you perform a mitral valve repair versus a mitral valve replacement?
We repair as often as we can. This is because we know that survival and quality of life are better with a repair.
On the other hand, there are many different types of valve pathology. Some valves will not hold up over time, no matter how well you repair them, so certain patients will need their valve replaced.
We have to determine if it’s a repairable valve or if we should skip that step and go directly to replacement, but the initial goal is to repair it whenever possible.
How do you decide if a mitral valve repair can be minimally invasive?
It depends on past surgical history and if a patient’s lungs can tolerate a surgery that goes through the chest as opposed to the sternum.
Technically, we can do almost any procedure minimally invasively. But the questions are, is it safe for the patient and can you get the same outcome and level of quality as you would through a traditional sternotomy.
Patients sometimes get fixated on a procedure being minimally invasive. That can detract from the primary goal, which is to do the best repair for that patient’s condition. It’s not the way you do it that counts. It’s what’s best for the patient in the long run.
What can patients generally expect after mitral valve repair surgery?
Prior to surgery, when their mitral valve isn’t functioning well, blood regurgitates backward and they’re not able to eject blood efficiently. They’ll feel fatigued and short of breath, and they won’t have the same energy level.
After that valve is repaired, a patient’s heart ejects blood much more efficiently. It delivers blood to the brain, so a patient is more alert. It delivers more blood to the muscles, so a patient’s GI tract improves (before surgery, some patients have pain after they eat because of lack of blood to their GI tract).
All of this is improved after a successful repair or replacement. The improvement in quality of life is significant. Patients also go back to the same survival curve they would have been on had they not had a valve lesion.