Questions and Answers about Mitral Valve Surgery
Specialties: Minimally invasive mitral valve, aortic valve, and tricuspid valve surgery; mitral valve repair, surgical treatment and minimally invasive surgery for atrial fibrillation; off-pump coronary artery bypass surgery; and high-risk mitral valve surgery.
I’m Dr. Marc Gillinov from the Miller Family Heart & Vascular Institute at the Cleveland Clinic.
At the Cleveland Clinic, we have the nation’s largest experience with surgery for heart valve disease. One of the most common indications for heart valve surgery is a problem with the mitral valve. The mitral valve might become a problem either because it leaks or is regurgative, or alternatively is narrowed, or stenotic. Today, the most common indication for mitral valve surgery is a leaky and regurgative valve.
People who have mitral regurgitation may experience shortness of breath, fatigue, decreased exercise tolerance, or swelling of the ankles. Alternatively, people with mitral regurgitation may have no symptoms whatsoever. The diagnosis of mitral regurgitation begins with detection of a murmur using a stethoscope. The diagnosis is confirmed by echocardiography, or an ultrasound of the heart.
Surgery is indicated for mitral regurgitation when the leak is severe. In addition, the patient should have symptoms or a change in heart size, or heart function. With recent advances today, we also recommend surgery in certain asymptomatic people with severe mitral regurgitation. The reason for recommending surgery for certain asymptomatic people is that the leak will not go away on its own and, if left untreated, severe mitral regurgitation leads to irreversible heart damage and to early death. In almost all cases, a leaky mitral valve can be repaired and mitral valve repair is generally preferred to mitral valve replacement. In addition, using current technology more than 90 percent of the time we can repair theses valves with a minimally invasive approach.
The risk of this surgery has decreased dramatically and is currently approximately 1 in 1000. So today most mitral valves can be repaired, the operation can be preformed minimally invasively, and the operation is safer than it has ever been.
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