Our Summary

Mitral regurgitation, a common heart valve disease, especially in people over the age of 65, often requires open-heart surgery to be treated. However, for patients who are at high risk for such surgery, new minimally invasive technologies are being developed to fix the mitral valve. These procedures are challenging because of the unique features of the mitral valve. Currently, several devices are being studied for replacing or repairing the mitral valve, with the MitraClip being the only one approved by the FDA. There are also several devices being tested that target different parts of the mitral valve. More than 10 different valves that can be inserted via minimally invasive procedures are being developed and tested. These valves can be inserted through different approaches. It’s expected that these less invasive treatments will become more common, particularly for older or more unwell patients.

FAQs

  1. What is the only FDA-approved device for mitral valve replacement or repair?
  2. Are there any minimally invasive procedures for mitral valve replacement currently under development?
  3. Who are the primary candidates for less invasive mitral valve treatments?

Doctor’s Tip

A doctor may advise a patient undergoing mitral valve replacement to closely follow post-operative care instructions, including taking prescribed medications, attending follow-up appointments, and participating in cardiac rehabilitation. It is important for patients to listen to their body and report any new symptoms or concerns to their healthcare provider promptly. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and avoiding tobacco and excessive alcohol can help support the success of the mitral valve replacement procedure.

Suitable For

Patients who are typically recommended mitral valve replacement are those who have severe mitral regurgitation, which can lead to symptoms such as shortness of breath, fatigue, and heart palpitations. These patients may also have a history of heart failure, atrial fibrillation, or other heart conditions. Additionally, patients who are at high risk for traditional open-heart surgery, such as older patients or those with multiple comorbidities, may be good candidates for minimally invasive mitral valve replacement procedures.

Timeline

Before Mitral Valve Replacement:

  • Patient experiences symptoms of mitral regurgitation, such as fatigue, shortness of breath, and heart palpitations.
  • Patient undergoes diagnostic tests, such as echocardiogram, to confirm the diagnosis.
  • Patient is evaluated by a cardiologist and a cardiac surgeon to determine the best course of treatment.
  • Patient may be prescribed medications to manage symptoms and improve heart function.

After Mitral Valve Replacement:

  • Patient undergoes pre-operative testing and evaluation to assess overall health and fitness for surgery.
  • Patient undergoes open-heart surgery to replace the damaged mitral valve with a prosthetic valve.
  • Patient is monitored closely in the intensive care unit post-surgery to ensure proper healing.
  • Patient undergoes cardiac rehabilitation to regain strength and improve cardiovascular health.
  • Patient may need to take medications for the rest of their life to prevent complications and maintain heart function.
  • Patient will have regular follow-up appointments with their cardiologist to monitor the function of the new valve and overall heart health.

What to Ask Your Doctor

  1. What are the risks and benefits of mitral valve replacement surgery compared to other treatment options?

  2. How experienced are you in performing mitral valve replacement surgeries and what is your success rate?

  3. What type of mitral valve replacement procedure do you recommend for me and why?

  4. What is the recovery process like after mitral valve replacement surgery? How long will it take for me to fully recover?

  5. What lifestyle changes will I need to make after mitral valve replacement surgery?

  6. Will I need to take any medications after the surgery? If so, what are the potential side effects and how long will I need to take them?

  7. What are the long-term effects of mitral valve replacement surgery?

  8. How often will I need follow-up appointments after the surgery?

  9. Are there any restrictions on physical activity or diet after mitral valve replacement surgery?

  10. What signs or symptoms should I watch out for that may indicate a complication after the surgery?

Reference

Authors: Kohorst K, Pretorius M. Journal: Semin Cardiothorac Vasc Anesth. 2019 Mar;23(1):123-133. doi: 10.1177/1089253218779787. Epub 2018 Jun 13. PMID: 29897014