Our Summary

This research paper talks about how mitral valve surgery has changed over the past 40 years. Earlier, the surgery relied on replacing the faulty valve with an artificial one. However, now the focus has shifted to repairing the damaged valve instead. The paper aims to list the modern techniques used in mitral valve repair and how to decide which technique to use based on the specific disease and related complications. The paper is particularly focused on degenerative diseases. It also discusses the role of cardiac anesthesia, cardiac surgery, intraoperative assessment, and transesophageal echocardiography in these procedures.

FAQs

  1. How has mitral valve surgery evolved over the past four decades?
  2. What are the contemporary techniques of mitral valve repair?
  3. How are these mitral valve repair techniques applied in a pathoanatomically directed approach?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve repair is to follow a heart-healthy diet and maintain a regular exercise routine to help support the success of the surgery and promote overall heart health. It is also important to follow all post-operative care instructions provided by your healthcare team to ensure a smooth recovery and optimal outcome.

Suitable For

Patients who are typically recommended mitral valve repair are those with degenerative mitral valve disease, such as mitral valve prolapse or mitral regurgitation. Patients who are relatively young, have good left ventricular function, and do not have significant comorbidities are often good candidates for mitral valve repair. Additionally, patients who have a structurally normal mitral valve and who do not have severe calcification or scarring of the valve leaflets are also good candidates for repair. Mitral valve repair is preferred over replacement whenever possible, as it is associated with better long-term outcomes and a lower risk of complications.

Timeline

Before mitral valve repair:

  1. Patient presents with symptoms such as shortness of breath, fatigue, chest pain, or palpitations.
  2. Patient undergoes diagnostic tests such as echocardiogram and cardiac catheterization to confirm mitral valve disease.
  3. Patient consults with a cardiac surgeon to discuss treatment options, including mitral valve repair.
  4. Patient undergoes preoperative evaluations and preparation for surgery.

After mitral valve repair:

  1. Patient undergoes mitral valve repair surgery, which may involve techniques such as leaflet resection, annuloplasty, or chordal reconstruction.
  2. Patient is monitored closely in the intensive care unit postoperatively for any complications.
  3. Patient begins a rehabilitation program to regain strength and function.
  4. Patient undergoes follow-up appointments with their cardiac surgeon to monitor the success of the repair and ensure proper healing.
  5. Patient may experience improvements in symptoms such as improved exercise tolerance and reduced risk of complications associated with mitral valve disease.

What to Ask Your Doctor

  1. What is the reason for recommending mitral valve repair over replacement?
  2. What are the potential risks and benefits of mitral valve repair surgery?
  3. How long is the recovery period after mitral valve repair surgery?
  4. Will I need to take medication after the surgery, and if so, for how long?
  5. What lifestyle changes, if any, will I need to make after mitral valve repair surgery?
  6. How often will I need follow-up appointments after the surgery?
  7. Are there any restrictions on physical activity or diet following mitral valve repair surgery?
  8. What are the success rates for mitral valve repair surgery in cases similar to mine?
  9. What are the potential complications or side effects of mitral valve repair surgery?
  10. Are there any alternative treatments or procedures that could be considered for mitral valve repair?

Reference

Authors: Alreshidan M, Herron RD, Wei LM, Cook CC, Salman M, Roberts HG, Badhwar V. Journal: Semin Cardiothorac Vasc Anesth. 2019 Mar;23(1):20-25. doi: 10.1177/1089253218815465. Epub 2018 Dec 5. PMID: 30516443