Our Summary

This paper discusses recent developments in procedures to repair or replace the mitral valve in the heart without needing open-heart surgery. Two recent trials examining the success of a device called MitraClip showed conflicting results, leading to a new way of thinking about how to assess the severity of mitral regurgitation (leakage of blood backwards through the mitral valve). This includes monitoring the pressure in the left atrium of the heart in real time. The paper also discusses how the experience of the surgeon affects the success of the procedure, with more experienced surgeons achieving better results. It talks about several ongoing trials of new devices and methods for mitral valve repair, particularly for patients who are at high risk from surgery or have complex valve problems. The early results of these trials are encouraging.

FAQs

  1. What is the MitraClip and how does it relate to mitral valve repair?
  2. How does the experience of the surgeon affect the success of mitral valve repair procedures?
  3. What new methods and devices for mitral valve repair are currently being trialed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about mitral valve repair is to follow a healthy lifestyle, including eating a balanced diet, exercising regularly, maintaining a healthy weight, and avoiding smoking. These lifestyle changes can help improve the overall health of the heart and may reduce the risk of complications following mitral valve repair surgery. Additionally, it is important to follow all post-operative instructions provided by the medical team and attend follow-up appointments to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for mitral valve repair include those with mitral regurgitation (leakage of blood backwards through the mitral valve) that is severe and causing symptoms such as shortness of breath, fatigue, and heart palpitations. Patients with mitral valve prolapse, a condition where the valve does not close properly, may also be recommended for repair. Additionally, patients who are at high risk for traditional open-heart surgery or who have complex valve problems may be candidates for minimally invasive mitral valve repair procedures.

Timeline

Before mitral valve repair:

  • Patient may experience symptoms such as shortness of breath, fatigue, chest pain, and palpitations
  • Patient undergoes diagnostic tests such as echocardiogram, MRI, and cardiac catheterization to assess the severity of the mitral valve disorder
  • Patient consults with a cardiologist and cardiac surgeon to discuss treatment options
  • Patient may be prescribed medications to manage symptoms before surgery

After mitral valve repair:

  • Patient undergoes minimally invasive mitral valve repair procedure, such as MitraClip implantation or other surgical techniques
  • Patient is monitored closely in the hospital for any complications or signs of improvement
  • Patient may need to participate in cardiac rehabilitation to regain strength and endurance
  • Patient continues to follow up with cardiologist for regular check-ups and monitoring of the repaired valve
  • Patient may experience improved symptoms and quality of life following successful mitral valve repair.

What to Ask Your Doctor

  1. What are the potential risks and benefits of mitral valve repair surgery compared to other treatment options?
  2. How experienced are you in performing mitral valve repair procedures, and what is your success rate?
  3. Can you explain the specific technique you plan to use for my mitral valve repair?
  4. How long is the recovery period after mitral valve repair surgery, and what can I expect during the recovery process?
  5. Are there any lifestyle changes or medications I will need to take after mitral valve repair surgery?
  6. What are the long-term outcomes and potential complications associated with mitral valve repair surgery?
  7. Are there any alternative treatments or procedures available for my mitral valve condition?
  8. Will I need follow-up appointments or ongoing monitoring after mitral valve repair surgery?
  9. How will mitral valve repair surgery improve my overall heart function and quality of life?
  10. Are there any clinical trials or new technologies available for mitral valve repair that I should consider?

Reference

Authors: Kang JJH, Bozso SJ, El-Andari R, Adams C, Nagendran J. Journal: Curr Opin Cardiol. 2021 Mar 1;36(2):163-171. doi: 10.1097/HCO.0000000000000803. PMID: 33044266