Blood flows to your heart in order to pick up more oxygen from your lungs. It comes into your right atrium before moving into your right ventricle. It then flows to your lungs before returning to the left atrium. From there, it moves into the left ventricle before leaving your heart and flowing into the aorta on its way to your other organs.
This blood flow between the four chambers of your heart and your lungs is made possible by a series of valves. One of them is called the mitral valve (MV). It controls the passage of blood between your left atrium and left ventricle. Below, we'll describe two disorders that can prevent the MV from working properly. We'll also explain the most effective mitral valve repair techniques in use today.
Stenosis And Prolapse
Stenosis is defined as a narrowing of the diseased valve. The MV's two leaflets harden or stiffen, and fail to open wide enough to allow a sufficient amount of blood to flow from the atrium to the ventricle. The root cause of this disorder is usually rheumatic fever experienced by the patient as a child. Infection triggers the body's immune system, which attacks the leaflets. Due to widespread use of medications, few people in the U.S. suffer from rheumatic fever today. As a result, mitral stenosis is rare when compared to prolapse.
Prolapse is defined as an inability to close effectively. In cases where it affects the mitral valve, one or both of the leaflets flap back into the left atrium when the left ventricle contracts. This causes blood to flow back into the atrium, a condition known as regurgitation. It can lead to infection, arrhythmias, clotting, and other complications.
Mitral Valve Repair Techniques
A stenotic MV is usually repaired through a procedure called balloon valvuloplasty. A balloon is placed on the tip of a catheter and guided to the stenotic valve. It is positioned between the stiffened leaflets and expanded to widen the opening.
Prolapse is treated based on which of the two leaflets is affected: posterior or anterior. The posterior leaflet can be repaired with a procedure called triangular resection. The surgeon will remove abnormal sections by cutting a small triangular area into the leaflet. Once the sections have been removed, the edges of the leaflet are sewn together.
Mitral valve repair performed on the anterior leaflet is more complicated. It requires the surgeon to either transfer supporting chords from another piece of the MV or to create new chords using a synthetic material. In the latter case, there are rarely complications.
What To Expect After Surgery
Mitral valve repair was once performed exclusively through open heart surgery. A long incision was made into the patient's chest and the breastbone was separated to give the surgeon access to the heart. It was an invasive operation that required a long recovery period.
Today, surgery to repair stenosis and prolapse is performed with minimally invasive methods. These techniques can be done without opening the patient's chest. This introduces several key benefits.
First, the recovery period following surgery is much shorter than in the past. Second, the likelihood of infection, bleeding, and other complications is much lower. Third, doctors used to replace the MV rather than attempt to repair it. This usually required the patient to take anticoagulant drugs for the remainder of his or her life. With mitral valve repair, anticoagulants are no longer necessary. Lastly, these minimally invasive techniques preserve more of the heart's natural ability to circulate blood throughout the body.
If you suffer from symptoms stemming from stenosis or prolapse, mitral valve repair surgery may be a viable solution. Ask your physician whether the procedure makes sense given your condition and circumstances.