With proper patient selection and timely intervention, the estimated success rate of mitral valve repair surgery is around 95%. Almost 95% of patients are free of reoperation for 10 years. At 20 years, around 90% of people do not need reoperation for mitral valve repair.
What is percutaneous mitral valve repair surgery?
Percutaneous mitral valve repair is a surgery to repair a leaky mitral valve (mitral regurgitation). A thin, flexible tube (catheter) carrying a special device is passed through the skin (percutaneously) into the heart during this procedure.
The heart has four chambers, the upper two are called atria and the lower two chambers are called ventricles. Four valves guard the flow of blood through the heart. These valves ensure an adequate flow of blood in a single direction and prevent any backflow. The four heart valves are
- Mitral valve: Located between the left atrium and the left ventricle.
- Tricuspid valve: Located between the right atrium and the right ventricle.
- Pulmonary valve: Located between the right ventricle and the pulmonary artery (the blood vessel that carries blood from the heart to the lungs).
- Aortic valve: Located between the left ventricle and the aorta (the blood vessel that carries oxygenated blood from the heart).
The mitral valve opens when the left atrium contracts (atrial systole) and the left ventricle relaxes (ventricular diastole), simultaneously. The mitral valve closes when the left atrium relaxes (atrial diastole) and the left ventricle contracts (ventricular systole). Thus, the closing of the mitral valve prevents the backflow of blood from the left ventricle and ensures the forward flow from the left ventricle to the aorta.
In some health conditions, the mitral valve fails to close properly and results in the reverse flow of blood into the left atrium (mitral regurgitation) during the left ventricle contraction. This will hamper an adequate flow of blood from the heart to the body and may produce several complications depending on the severity.
In percutaneous repair of a leaky mitral valve, doctors insert a long, thin tube (catheter) through the skin (percutaneously) in an artery in the groin and guide it to the mitral valve. The catheter is used to insert a clip or another special device to repair the defects in a leaking mitral valve.
Is mitral valve repair a major surgery?
Mitral valve repair constitutes a major procedure. It may be performed during an open-heart surgery, which involves definite risk with respect to incision size, anesthesia, and infection risks. In around 60-80% cases, the mitral valve repair can be done through a small (2 to 4 inch) skin incision on the right side of the chest. With the advancements in surgical care, the surgical robot further limits the incision size to 1 inch. Even in these cases, the ICU stay is mandated for the first 24 hours after the surgery, and because anesthesia risks are present, the repairs done via robotic or laparoscopic methods, which also fall under major surgery.
What are the advantages of a percutaneous mitral valve repair surgery?
The advantages of the percutaneous mitral valve repair surgery are:
- Better quality of life
- Increased early and late survival
- Improved lifestyle
- Adequate preservation of heart function
- Lower risk of stroke and endocarditis (infection of heart)
- No need for using anticoagulants (blood thinners)
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