Our Summary

This study looked at two different methods of fixing a faulty heart valve (the mitral valve) and compared how well patients did after these procedures. The two methods are called ‘minimally invasive mitral valve repair’ and ‘chordal-sparing mitral valve replacement’. Between 2009 and 2015, 960 patients had the repair procedure, while 95 patients had the replacement procedure.

The researchers matched patients from each group based on their health status and other factors, and compared how they did over the next 7 years. They found that about 76% of the repair group and 79% of the replacement group were still alive after 7 years, which wasn’t a big enough difference to be statistically significant.

They also looked at the rates of major heart and brain problems (like strokes or heart attacks), and found no significant difference between the two groups. Very few patients in either group needed to have their valve fixed again.

When they looked at all the patients together, the risk of death was slightly higher in the replacement group compared to the repair group, but this difference wasn’t statistically significant either.

In simpler terms, this means that both methods seem to work pretty well, and it doesn’t make a big difference which one patients get.

FAQs

  1. What are the two methods of mitral valve repair examined in this study?
  2. Was there a significant difference in survival rates between the groups that had mitral valve repair versus replacement?
  3. Does the study suggest one method of mitral valve treatment is more effective than the other?

Doctor’s Tip

However, your doctor may recommend one over the other based on your individual health situation and the specific characteristics of your mitral valve issue. Make sure to discuss all your options with your doctor and ask any questions you may have before making a decision. It’s important to follow your doctor’s recommendations and attend all follow-up appointments to ensure the best outcome after your mitral valve replacement procedure.

Suitable For

Patients who are typically recommended for mitral valve replacement are those with severe mitral valve disease that cannot be effectively treated with repair techniques. This may include patients with severe mitral regurgitation or stenosis, as well as those with complex valve anatomy that makes repair difficult.

Patients who are younger and in good overall health may be candidates for minimally invasive mitral valve repair, as this procedure is less invasive and has a quicker recovery time compared to valve replacement. However, in some cases, valve replacement may be necessary if repair is not possible or if the patient’s valve disease is too severe.

Ultimately, the decision to recommend mitral valve replacement will depend on the individual patient’s specific circumstances, including the severity of their valve disease, their overall health, and their preferences for treatment. It is important for patients to discuss their options with their healthcare provider to determine the best course of action for their specific situation.

Timeline

Before mitral valve replacement:

  • Patient undergoes diagnostic testing such as echocardiogram to assess the severity of the mitral valve disease
  • Patient may experience symptoms such as shortness of breath, fatigue, chest pain, and palpitations
  • Cardiologist and cardiac surgeon discuss treatment options and decide on mitral valve replacement as the best course of action
  • Patient undergoes pre-operative testing and preparation for surgery

After mitral valve replacement:

  • Patient undergoes mitral valve replacement surgery, either through minimally invasive repair or chordal-sparing replacement
  • Patient is monitored closely in the intensive care unit after surgery
  • Patient undergoes rehabilitation and physical therapy to regain strength and mobility
  • Patient is discharged from the hospital and continues to follow up with their healthcare team for monitoring and management of any complications
  • Patient may need to take medications such as blood thinners and antibiotics to prevent infection and blood clots
  • Patient gradually resumes normal activities and lifestyle, with regular follow-up appointments to monitor the function of the new valve.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mitral valve replacement include:

  1. What are the risks and benefits of minimally invasive mitral valve repair versus chordal-sparing mitral valve replacement?
  2. How will I know which procedure is the best option for me?
  3. What is the success rate of each procedure in terms of improving symptoms and overall heart function?
  4. What is the expected recovery time for each procedure?
  5. What are the potential complications or side effects of mitral valve replacement?
  6. Will I need to take medications after the procedure, and if so, for how long?
  7. How often will I need follow-up appointments to monitor my heart health after the procedure?
  8. Are there any lifestyle changes or restrictions I should be aware of after mitral valve replacement?
  9. How long do the results of mitral valve replacement typically last?
  10. Are there any alternative treatment options I should consider?

Reference

Authors: Hata M, Zittermann A, Hakim-Meibodi K, Börgermann J, Gummert J. Journal: Interact Cardiovasc Thorac Surg. 2019 Apr 1;28(4):575-580. doi: 10.1093/icvts/ivy305. PMID: 30476075