Mitral Valve Repair

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Mitral Valve Repair

Mitral valve repair can be done in two ways. “Balloon Valvuloplasty” is a cardiac catheterization procedure mostly performed for patients with Mitral Stenosis. An interventional cardiologist does this procedure. A catheter with a balloon at the end of it is placed in the mitral valve opening and inflated. This forces the valves to open, allowing better blood flow through the valves.

Balloon valvuloplasty cannot be performed in patients with calcified mitral valves, presence of blood clots or severe mitral valve regurgitation.

“Open Commissurotomy” is performed mostly on patients with mitral regurgitation. This is an open-heart procedure performed by cardio-thoracic surgeons. Just suturing the cleft in patients with congenital cleft leaflets, controls the mitral regurgitation.

Excess tissues from the leaflets are removed and the cusps are reshaped. Annuloplasty is where the enlarged annulus or the base of the valve is repaired and supported by an artificial band or ring.

Chordae tendinae are reconstructed if needed using sutures. Any calcium deposits present in the valves are carefully removed.

Recent studies show that early intervention and repair of mitral valve can prevent irreversible heart damage.

Repair holds better outcome for patients with degenerative disease. Depending on the cause of mitral regurgitation, a simple repair has 85-90% chance of a patient not needing further intervention for the next 10 years.

Rheumatic valves are better replaced than repaired because they are usually both stenotic and regurgitant.

Valves damaged due to bacterial infection are occasionally repaired.

Isolated mitral valve disease is repaired using the minimally invasive method, where the heart is exposed by a 2-3 inch incision on the right chest or middle of the sternum. The procedure can also be performed using a robotic device that helps in doing a more precise surgery.

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Methods for Mitral Valve Repair: Annuloplasty:In annuloplasty an artificial ring is placed around the annulus of the valve.This ring reinforces the annulus and restores the valve to its normal shape and size. Balloon Valvuloplasty:Balloon valvuloplasty is performed using a catheter, i.e. a very thin flexible tube which can be inserted into the body, with a balloon at the end. The balloon is put inside the valve and is expanded thus stretching the valve and bringing it back to its normal size. For more info:

Patients with a biological valve may need replacement valve of 10-15 years. Mechanical valves may also fail, so patients should inform their doctor if they have symptoms of valve insufficiency. Patients with mechanical valves must take blood-thinning medication at the end of their lives. Because these medicines increase the risk of bleeding in the body, you should always be used in medical notification bracelet and the doctor or dentist that you are taking anticoagulant medicine. Even if you take anticoagulant medication, you should always inform your doctor and dentist to have had valve surgery. If you have any surgery or dentistry, you should take antibiotics before the procedure. The bacteria can enter the bloodstream during these procedures. If bacteria enter the repair or artificial heart valves, can lead to a serious condition called bacterial endocarditis. Antibiotics can prevent bacterial endocarditis.

Mitral Regurgitation also known as mitral insufficiency or mitral incompetence is a disorder affecting the mitral valve of the heart. The cusps or flaps of the mitral valve do not seal tightly in this condition and causes a backflow of blood through the mitral valve from the left ventricle to the let atrium of the heart. The heart valve in this state is referred to as a leaky valve.

Various symptoms are
* Shortness of breath.
* Pulmonary edema or fluid accumulation in the lungs.
* Orthopnea or shortness of breath while lying flat.
* Paroxysmal nocturnal dyspnea or Cardiac Asthma
* Decreased exercise tolerance.
* Swollen feet or ankles.

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