Our Summary

This study looked at the outcomes of patients who underwent surgery to fix leaks around their artificial heart valves (mitral para-prosthetic leaks), a rare but serious complication of heart valve replacements. By examining medical records from 1996 to 2016, the researchers found that the surgery had a mortality rate of 11.7%, with conditions like endocarditis (heart infection) and high levels of a certain enzyme (lactate dehydrogenase) increasing the risk of death. The type of surgical treatment didn’t seem to affect the risk of complications or death. However, about a third of the patients experienced a recurrence of the leak. The authors concluded that these surgeries carry a high risk and the chosen surgical approach can impact the patient’s outcome.

FAQs

  1. What is a mitral para-prosthetic leak and how often does it occur?
  2. What factors were found to increase the risk of death after surgery for mitral para-prosthetic leaks?
  3. Does the type of surgical treatment impact the risk of complications or death in patients having surgery for mitral para-prosthetic leaks?

Doctor’s Tip

A doctor might tell a patient undergoing mitral valve replacement to closely follow post-operative care instructions, attend all follow-up appointments, and promptly report any new or worsening symptoms to their healthcare provider. It is important to monitor for signs of infection or other complications and to adhere to any prescribed medications or lifestyle changes to optimize recovery and reduce the risk of complications.

Suitable For

Patients who are typically recommended mitral valve replacement include those with severe mitral valve regurgitation (leaking of the valve), mitral valve stenosis (narrowing of the valve), or mitral valve prolapse (flaps of the valve bulging back into the left atrium). These conditions can lead to symptoms such as shortness of breath, fatigue, palpitations, chest pain, and heart failure. Patients who have failed conservative treatments or are at high risk for complications from their mitral valve disease may be candidates for mitral valve replacement surgery.

Timeline

  • Patient is diagnosed with mitral valve disease, leading to symptoms such as shortness of breath, fatigue, and heart palpitations.
  • Patient undergoes various tests and evaluations to determine the severity of the condition and the need for surgery.
  • Patient is scheduled for mitral valve replacement surgery, which may be performed through traditional open-heart surgery or minimally invasive techniques.
  • Patient undergoes surgery to replace the damaged mitral valve with a mechanical or biological prosthetic valve.
  • After surgery, patient is monitored closely in the hospital for complications such as infection, bleeding, or irregular heart rhythms.
  • Patient undergoes cardiac rehabilitation and follow-up appointments to monitor the function of the new valve and overall heart health.
  • Over time, patient may experience improvements in symptoms such as improved exercise tolerance and reduced risk of heart failure.
  • Long-term follow-up is necessary to monitor the function of the prosthetic valve and address any potential complications that may arise.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with mitral valve replacement surgery?
  2. What are the success rates and outcomes of mitral valve replacement surgery?
  3. How will my overall health and any pre-existing conditions affect my candidacy for mitral valve replacement surgery?
  4. What is the recovery process like after mitral valve replacement surgery?
  5. How long will I need to stay in the hospital following the surgery?
  6. What lifestyle changes or precautions should I take after undergoing mitral valve replacement surgery?
  7. Will I need to take any medications after the surgery, and for how long?
  8. What follow-up appointments or tests will be necessary to monitor my heart health post-surgery?
  9. What signs or symptoms should I watch for that may indicate a complication or issue with the mitral valve replacement?
  10. Are there any alternative treatments or procedures that could be considered instead of mitral valve replacement surgery?

Reference

Authors: Dziubek M, Pierrakos C, Chebli L, Demanet H, Sanoussi A, Wauthy P. Journal: Curr Cardiol Rev. 2018 Mar 14;14(1):15-24. doi: 10.2174/1573403X13666171110110344. PMID: 29141552