Our Summary

This research paper evaluates the outcomes of two different heart surgeries: mitral valve (MV) repair and MV replacement with preservation of the entire subvalvular apparatus (the structure below the valve). The study looked at 82 patients who had one of these surgeries between 2012 and 2017. They found that the two groups had similar rates of mortality, long-term survival, and complications. In other words, both types of surgeries had similar outcomes, and there were no deaths in either group due to heart-related issues. The study suggests that MV replacement with preservation of the entire subvalvular apparatus is just as good as MV repair. This is important as it can help doctors to make the best decision for their patients’ treatment.

FAQs

  1. What were the two types of heart surgeries evaluated in the research paper?
  2. What were the outcomes of the study comparing mitral valve repair and mitral valve replacement with preservation of the entire subvalvular apparatus?
  3. Why is the study on mitral valve replacement with preservation of the entire subvalvular apparatus important for doctors?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve replacement is to follow a healthy lifestyle post-surgery to support the success of the procedure. This can include maintaining a balanced diet, regular exercise, managing stress levels, and quitting smoking if applicable. Additionally, it’s important to attend follow-up appointments with your healthcare provider to monitor your heart health and address any concerns. By taking care of your overall well-being, you can optimize the benefits of the mitral valve replacement surgery and improve your long-term outcomes.

Suitable For

Patients who are typically recommended mitral valve replacement include those with severe mitral valve disease, such as severe mitral regurgitation or mitral stenosis, that cannot be effectively treated with other interventions such as medication or less invasive procedures like mitral valve repair. Patients with a severely damaged or diseased mitral valve, or those with structural abnormalities that cannot be repaired, may also be candidates for mitral valve replacement. Additionally, patients who have previously undergone unsuccessful mitral valve repair may be recommended for mitral valve replacement. Ultimately, the decision to recommend mitral valve replacement is based on the individual patient’s specific condition, overall health, and the expertise of their medical team.

Timeline

  • Before mitral valve replacement:
  1. Patient experiences symptoms of mitral valve disease, such as shortness of breath, fatigue, palpitations, and chest pain.
  2. Patient undergoes diagnostic tests, such as echocardiograms and cardiac catheterization, to confirm the diagnosis and assess the severity of the condition.
  3. Patient is evaluated by a cardiovascular surgeon to determine if mitral valve replacement is necessary and if they are a suitable candidate for the surgery.
  4. Patient undergoes preoperative testing and preparation for the surgery, including medications, imaging tests, and consultations with other healthcare providers.
  • After mitral valve replacement:
  1. Patient undergoes the surgical procedure, which involves removing the damaged mitral valve and replacing it with a mechanical or bioprosthetic valve.
  2. Patient is closely monitored in the intensive care unit (ICU) immediately after surgery for any complications or issues.
  3. Patient is gradually weaned off of mechanical ventilation and other supportive measures as they recover from the surgery.
  4. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  5. Patient is discharged from the hospital and continues follow-up care with their healthcare team to monitor their recovery and manage any complications or issues that may arise.
  6. Patient may need to take medications, such as blood thinners or heart medications, for the rest of their life to prevent complications and maintain heart health.

What to Ask Your Doctor

  1. What is the reason for recommending a mitral valve replacement over a repair?
  2. What are the potential risks and complications associated with mitral valve replacement surgery?
  3. How long is the recovery time after mitral valve replacement surgery?
  4. Will I need to take medication for the rest of my life after the surgery?
  5. How often will I need to follow up with a cardiologist after the surgery?
  6. Are there any lifestyle changes I should make after the surgery to improve my heart health?
  7. Will I need to undergo any additional tests or procedures after the surgery?
  8. What is the long-term prognosis for someone who has undergone mitral valve replacement surgery?
  9. Are there any specific symptoms or signs I should watch out for after the surgery that may indicate a complication?
  10. Are there any restrictions on activities or exercise following mitral valve replacement surgery?

Reference

Authors: Kisamori E, Otani S, Yamamoto T, Nishiki M, Yamada Y, Matsumoto T. Journal: Gen Thorac Cardiovasc Surg. 2019 May;67(5):436-441. doi: 10.1007/s11748-018-1039-2. Epub 2018 Nov 23. PMID: 30471048