Our Summary
This research paper discusses a common heart valve problem (mitral valve dysfunction) that often affects older patients. Many of these patients are not suitable for traditional surgery. A procedure known as mitral transcatheter edge-to-edge repair (TEER) can treat a large proportion of these patients, but many are not suitable for this procedure either. Another procedure, called orthotopic transcatheter mitral valve replacement (TMVR), could be an important solution, but it has significant challenges. The TMVR procedure requires a stable and enduring artificial heart valve, that fits perfectly in the heart without occupying too much space. This procedure also requires a team of specialists in areas such as advanced imaging, surgery, and heart failure in order to be successful.
FAQs
- What is orthotopic transcatheter mitral valve replacement (TMVR)?
- What are the challenges faced by orthotopic TMVR and how can they be addressed?
- Who is not a suitable candidate for mitral transcatheter edge-to-edge repair (TEER)?
Doctor’s Tip
One helpful tip a doctor might tell a patient about mitral valve replacement is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and participating in cardiac rehabilitation programs to support recovery and long-term success of the replacement valve.
Suitable For
Patients who are typically recommended for mitral valve replacement are those who have severe mitral valve dysfunction that cannot be adequately treated with other interventions such as medication or surgery. These patients may have symptoms such as severe shortness of breath, fatigue, chest pain, and heart palpitations. They may also have complications such as heart failure, arrhythmias, or pulmonary hypertension. Additionally, patients who are not suitable candidates for other treatments, such as transcatheter edge-to-edge repair (TEER), may be recommended for mitral valve replacement. These patients may include those who have complex mitral valve anatomy, severe mitral regurgitation, or other factors that make them unsuitable for other treatments.
Timeline
- Patient experiences symptoms of mitral valve dysfunction such as shortness of breath, fatigue, and heart palpitations
- Patient undergoes initial evaluation and diagnostic tests to confirm mitral valve dysfunction
- Patient is informed about treatment options including mitral valve replacement
- Patient undergoes pre-operative testing and evaluation to assess suitability for surgery
- Patient undergoes mitral valve replacement surgery, either traditional open-heart surgery or minimally invasive transcatheter procedure
- Patient receives post-operative care and rehabilitation to recover from surgery
- Patient undergoes follow-up testing and monitoring to ensure the success of the mitral valve replacement
- Patient experiences improved symptoms and quality of life after mitral valve replacement.
What to Ask Your Doctor
- What is the reason for needing a mitral valve replacement?
- What are the different types of mitral valve replacement procedures available, and which one is recommended for my specific case?
- What are the potential risks and complications associated with the mitral valve replacement procedure?
- How long is the recovery period after the mitral valve replacement surgery?
- Will I need to take any medications or make any lifestyle changes after the surgery?
- How long can I expect the replacement valve to last?
- What follow-up appointments or tests will be necessary after the surgery?
- What are the signs and symptoms of any potential complications that I should watch out for?
- Are there any restrictions on physical activity or diet that I should be aware of after the surgery?
- Are there any additional resources or support groups available for patients undergoing mitral valve replacement surgery?
Reference
Authors: Eng MH, Zahr F. Journal: Interv Cardiol Clin. 2024 Apr;13(2):227-235. doi: 10.1016/j.iccl.2024.01.004. Epub 2024 Feb 2. PMID: 38432765