Our Summary

This research paper discusses a case where a patient with two failing heart valves, the mitral and tricuspid, was treated successfully using a newer method. This method, known as valve-in-valve replacement, involves placing a new valve within the failing one. This is particularly useful for patients who are high risk for traditional surgery. In this case, the procedure was done through small incisions in the apex of the heart (transapical) for the mitral valve, and through a vein in the neck (transjugular) for the tricuspid valve.

FAQs

  1. What is a mitral valve-in-valve replacement?
  2. How are failing mitral and tricuspid bioprostheses treated?
  3. What is a percutaneous transjugular tricuspid transcatheter valve-in-valve replacement?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve replacement is to follow up regularly with your healthcare provider to monitor the function of the new valve and ensure proper healing. It is important to report any new symptoms or changes in your condition to your doctor promptly. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support the success of the valve replacement surgery.

Suitable For

Patients who are typically recommended for mitral valve replacement include those with severe mitral valve stenosis or regurgitation that is causing symptoms such as shortness of breath, fatigue, chest pain, or heart failure. These patients may have previously undergone a mitral valve repair that has failed or a bioprosthetic valve that has deteriorated over time. In cases where the patient is at high risk for traditional open-heart surgery, transcatheter valve-in-valve replacement may be considered as a less invasive alternative.

Timeline

  1. Symptoms of mitral valve disease develop over time, such as shortness of breath, fatigue, and heart palpitations.
  2. Patient undergoes diagnostic tests such as echocardiogram and cardiac catheterization to confirm the diagnosis of mitral valve disease.
  3. Patient is evaluated by a cardiac surgeon and cardiologist to determine if they are a candidate for mitral valve replacement surgery.
  4. Mitral valve replacement surgery is performed either through traditional open-heart surgery or minimally invasive techniques.
  5. Patient undergoes post-operative recovery in the hospital, typically for several days to a week.
  6. Patient may undergo cardiac rehabilitation to regain strength and endurance after surgery.
  7. Patient will have regular follow-up appointments with their healthcare team to monitor their heart health and adjust medications as needed.

After mitral valve replacement:

  1. Patient experiences improvement in symptoms such as reduced shortness of breath and increased energy levels.
  2. Patient may need to take blood thinners and other medications to prevent blood clots and manage heart health.
  3. Patient may need to make lifestyle changes such as diet and exercise to maintain heart health.
  4. Patient will continue to have regular follow-up appointments with their healthcare team to monitor the function of the new mitral valve and overall heart health.

What to Ask Your Doctor

  1. What is the reason for needing a mitral valve replacement?
  2. What are the risks and benefits of mitral valve replacement surgery?
  3. What type of mitral valve replacement will be used (mechanical or tissue valve)?
  4. How long is the recovery process after mitral valve replacement surgery?
  5. What are the potential complications of mitral valve replacement surgery?
  6. How often will follow-up appointments be needed after mitral valve replacement surgery?
  7. What lifestyle changes may be necessary after mitral valve replacement surgery?
  8. Are there any restrictions on physical activity following mitral valve replacement surgery?
  9. How long can a mitral valve replacement be expected to last?
  10. What are the signs and symptoms of potential complications after mitral valve replacement surgery?

Reference

Authors: Ventosa-Fernandez G, Vidal L, Tarrio R, Gomez A, Peral V, Saez de Ibarra JI. Journal: Ann Thorac Surg. 2019 Oct;108(4):e241-e243. doi: 10.1016/j.athoracsur.2019.02.032. Epub 2019 Mar 21. PMID: 30905586