How Long Does A Mitral Valve Repair Last?

Overview

Mitral Valve Repair at Cleveland Clinic

At Cleveland Clinic nosotros have the world'south greatest feel with mitral valve repair, the best option for almost patients with a leaking mitral valve (mitral regurgitation).

Our surgeons take special expertise in mitral valve repair. As a event, at Cleveland Clinic, nearly all leaking mitral valves are repaired rather than replaced. A repair rate of almost 100% for patients with leaking mitral valves provides patients with ideal outcomes. And for those with isolated mitral valve problems, the majority of operations are performed robotically or minimally invasively, ensuring rapid recovery.

In 2022, patients traveled to Cleveland Clinic from all 50 states and 103 countries for their cardiovascular care.

What are the symptoms of a leaking mitral valve?

Many patients with mitral valve disease are asymptomatic (accept no symptoms), even with a leak that is severe. When symptoms develop, they include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations (actress or skipped eye beats).

How is a leaky mitral valve diagnosed?

The first step involves listening with a stethoscope. Using a stethoscope, the doctor hears a murmur, which represents turbulent blood flow across an abnormal valve. The diagnosis is confirmed past an echocardiogram. Ultrasound is used in an echocardiogram to allow the doctor to visualize the heart valves and determine the severity and cause of the leak. In virtually patients, a standard transthoracic echocardiogram (a probe placed on the skin of the breast) is adequate to visualize the valve. Sometimes a transesophageal echocardiogram (a probe passed through the rima oris into the esophagus) is necessary to more closely visualize the valve; this is an outpatient procedure.

What is mitral valve prolapse?

Mitral valve prolapse is a common condition in which the mitral valve leaflets are floppy or loose. Mitral valve prolapse is diagnosed by echocardiography. Almost patients with mitral valve prolapse practise not have a leaky valve and do not require surgery. When a valve with prolapse has a severe leak, surgery should be considered.

Mitral Valve Prolapse

What are the indications for surgical repair of a leaking mitral valve?

Surgery should exist considered when the leak is severe. In most facilities, the regurgitation (leak) is graded on a calibration from 0 to iv, with 0 being no leak and 4 being a severe leak.

Surgery should exist considered in about all patients with a leak that is graded as a 4 (astringent) and in some patients with a leak that is graded as a iii (moderately astringent). When a patient with mitral regurgitation develops symptoms, a decrease in heart part, or an increase in heart size, surgery is nearly always recommended. Surgery should also be considered when a patient develops atrial fibrillation, which is an irregular heartbeat. Surgery is besides recommended in most asymptomatic patients who have a severe leak. In asymptomatic patients with severe mitral regurgitation, surgery improves long-term survival. In dissimilarity, waiting for the development of symptoms or changes in heart role can go out patients with permanent heart impairment.

What is the hazard that a leaky mitral valve can exist repaired?

Most 100%. The well-nigh common crusade of mitral regurgitation is a condition chosen degenerative mitral valve disease—this is besides called mitral valve prolapse, myxomatous mitral valve affliction, and a floppy mitral valve. Such valves can be repaired (rather than replaced) in more than 95% of patients. Cleveland Clinic heart surgeons take the world's largest experience with mitral valve repair.

What is the gamble that a leaky mitral valve tin can exist repaired minimally invasively?

Approximately 60-eighty%. When a patient requires isolated mitral valve surgery for a degenerative valve, at Cleveland Clinic we can perform the operation through a 2 to 4 inch skin incision in in the majority of cases. Preoperative testing enables us to choose the safest arroyo for each patient. We offer several different minimally invasive approaches, including a pocket-sized incision on the correct chest, a small incision in the mid-line, and robotically assisted procedures. Expertise with several approaches enables us to determine the best procedure for each patient, optimizing results.

Procedure Details

Minimally Invasive Mitral Valve Repair

Cleveland Clinic surgeons are pioneers in the development of minimally invasive techniques for mitral valve repair. Today, the bulk of isolated mitral valve repairs can be performed through a 2-iii inch incision on the correct side of the chest. In many cases, we can employ the surgical robot and limit incision size to 1 inch.

Full Sternotomy

Partial Sternotomy

Right Thoracotomy

Robotic

Several minimally invasive approaches are available to patients. Minimally invasive approaches may also exist used for patients who require aortic valve or tricuspid valve surgery, lone or in combination with mitral valve surgery. In addition, Cleveland Clinic is a leader in percutaneous (through the pare) approaches to mitral valve repair, which may lead to additional treatment options in the futurity.

Advantages of minimally invasive approaches include faster recovery, less pain, reduced demand for blood transfusion and better cosmetic issue. We evaluate each patient for robotic and minimally invasive surgery and work with the patient to cull the best and safest approach in each case.

Learn nearly minimally invasive mitral valve repair: types of incisions, surgical options, photos and videos.

Mitral Valve Repair Surgery — Surgical Techniques

Cleveland Clinic surgeons take been instrumental in the development and application of modern mitral valve repair techniques. Problems with the posterior leaflet are mostly corrected past a pocket-size series of chords or a small resection of the abnormal portion of the valve. Anterior leaflet dysfunction is managed past creation of new chords or chordal transfer. Anterior leaflet repair techniques are technically challenging, requiring a skilled and experienced surgical team to achieve the best result. All repairs include an annuloplasty, which is a complete or partial ring placed around the circumference (rim) of the valve.

Mitral Valve Posterior Leaflet Prolapse — Valve Repair Surgery

During mitral valve repair middle surgery, triangular resection is the technique used well-nigh oftentimes for posterior leaflet prolapse.

Triangular Resection Mitral Valve Repair

Ruptured chords at complimentary border of posterior leaflet. Region to be resected is indicated.

Aberrant segment has been removed. Leaflet edges are sewn together.

Annuloplasty completes the repair.

Mitral Valve Inductive Leaflet Prolapse — Valve Repair Surgery

When there is mitral valve prolapse of the anterior leaflet, repair is more than complex and requires greater surgical expertise. To correct anterior leaflet prolapse caused by a ruptured or elongated chord, we commonly create new chords out of Gore-Tex. These Gore-Tex chords generally last forever. A second technique used for correction of inductive leaflet prolapse is chordal transfer, which involves transfer of chords from another office of the valve to the area with abnormal chords. Both techniques provide excellent long-term results for patients.

Gore-Tex® Chord for Correction of Anterior Leaflet Prolapse

Ruptured Chord

Afterward Chordal Repair

Chordae may be constructed from Gore-Tex® sutures. A Gore-Tex® suture is affixed to the head of the papillary muscle and then passed through the free edge of the unsupported anterior leaflet, providing support.

Long-term durability is excellent. The new chordae do non rupture or elongate.

Chordal Transfer to Treat Inductive Leaflet Prolapse

Chordal transfer to right anterior leaflet prolapse.

Posterior leaflet chordae are transferred to the unsupported gratuitous edge of the anterior leaflet. The posterior leaflet is and so repaired. A cloth annuloplasty band completes the repair.

Mitral Valve Repair — Special Situations

Mitral Valve Repair and Atrial Fibrillation

Many patients with mitral valve disease have atrial fibrillation, (an abnormal heart rhythm.) For these patients, at the time of mitral valve repair, Cleveland Clinic surgeons perform an ablation (Maze procedure) with the intent of curing the atrial fibrillation. In some patients with atrial fibrillation, a sternotomy (standard) approach may provide the best results.

Previous Mitral Valve Repair with Recurrent Mitral Regurgitation

In rare instances, a mitral valve repair may neglect over time. While almost surgeons supersede such valves, Cleveland Clinic surgeons can ofttimes re-repair these valves, offering excellent long-term immovability and the important advantages that go with mitral valve repair.

Previous Heart Surgery with Recurrent Mitral Regurgitation

Occasionally, a patient who has had previous bypass surgery, aortic valve surgery or other heart surgery develops a new problem with the mitral valve. In these re-operative settings, Cleveland Clinic surgeons tin safely and effectively repair nearly all leaking mitral valves.

Mitral Valve Repair for Endocarditis

When infection damages a mitral valve (endocarditis), repair is particularly challenging. Considering of their extensive feel with such patients, Cleveland Clinic surgeons successfully repair the mitral valve in the bulk of patients who accept had endocarditis.

Mitral Calcification

Occasionally, a patient with mitral regurgitation has extensive calcium deposits on the valve leaflets or annulus. The calcium makes repair difficult and requires application of avant-garde surgical techniques and sound judgment. Cleveland Clinic surgeons have the expertise to ensure fantabulous outcomes in patients with calcified mitral valves.

Mitral Valve Repair in Women with Breast Implants

We can normally perform a minimally invasive arroyo in women with breast implants. Working with a plastic surgeon, we remove the right breast implant through a small, cosmetic incision Nosotros then repair the mitral valve through the aforementioned incision. The plastic surgeon and so replaces the breast implant, often upgrading to a newer implant.

Risks / Benefits

Your Heart Valves

Advantages of Mitral Valve Repair: Why Repair Is Ameliorate Than Replacement

Mitral valve repair is the best option for nearly all patients with a leaking (regurgitant) mitral valve and for many with a narrowed (stenotic) mitral valve.

Compared to valve replacement, mitral valve repair provides better long-term survival, improve preservation of middle function, lower take chances of complications, and usually eliminates the need for long-term utilize of blood thinners (anticoagulants). For these reasons, Cleveland Clinic surgeons are committed to mitral valve repair, when possible.

Advantages of Mitral Valve Repair:

• Better early and belatedly survival (Longer life!)
• Improved lifestyle
• Better preservation of heart role
• Lower take chances of stroke and infection (endocarditis)
• No demand for blood thinners (anticoagulation)

Your Mitral Valve

Mitral Valve Chordae and Papillary Muscles

What is the risk of mitral valve surgery?

For asymptomatic patients having mitral valve repair, the operative take chances is approximately 1 in 1000. Risk in symptomatic patients remains well under 1%. The presence of coronary avenue disease or other weather condition that require surgical treatment will affect your private risk. Ask your md about your surgical gamble.

What is the immovability of a mitral valve repair?

After mitral valve repair, 95% of patients are free of reoperation at 10 years, and this figure is approximately 90% at 20 years. Thus, reoperation is uncommon after a successful mitral valve repair. An echocardiogram is recommended annually to assess valve office. In addition, patients who had valve surgery must take steps to prevent infection and reduce the risk of endocarditis (an infection of the valve).

Why is it important to have my surgery at a heart with a big experience in mitral valve repair?

Mitral valve repair is the all-time pick for nearly all patients with a leaking (regurgitant) mitral valve and for many with a narrowed (stenotic) mitral valve.Compared to valve replacement, mitral valve repair provides better long-term survival, better preservation of heart function, lower risk of complications, and usually avoids the need for long-term use of blood thinners (anticoagulation). For these reasons, Cleveland Clinic surgeons are committed to mitral valve repair.

Advantages of Mitral Valve Repair

• Better early and late survival
• Improved lifestyle
• Improve preservation of heart function
• Lower hazard of stroke and infection (endocarditis)
• No need for blood thinners (anticoagulation)

Mitral valve repair is more challenging than mitral valve replacement, and experienced surgeons are more probable to exist able to repair the valve and ensure an excellent result.

Resource

Doctors who treat

Cleveland Clinic has the nation's largest valve treatment program.

Doctors vary in quality due to differences in preparation and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and infirmary that yous choose for complex, specialized medical intendance will accept a direct impact on how well you do. To help you make this pick, please review our Miller Family Centre, Vascular & Thoracic Plant Outcomes.

Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons

• Valve Center
• Endocarditis Centre
• Mitral and Tricuspid Valve Center

The following Mitral Valve Heart surgeons specialize in mitral valve surgery:

• Marc Gillinov, MD* Section Chairman, Thoracic and Cardiovascular Surgery
• Daniel Burns, Medico*
• Kenneth McCurry, Dr.

*Performs robotically assisted mitral valve surgery

The Mitral and Tricuspid Valve Center surgeons offers expertise and experience to provide the best outcomes possible.

Departments and Sections:

Choosing a physician to treat your heart valve disease depends on where y'all are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Plant Sections and Departments treat patients with Centre Valve Disease:

Section of Thoracic and Cardiovascular Surgery : Surgeons in the Section of Thoracic and Cardiovascular Surgery are experts in the treatment of valve disease, including valve repair or replacement, minimally invasive centre valve surgery, and re-practise operations depending on the individual needs of the patient. For surgical review or more data, telephone call price-gratis 877.843.2781 (877-8Heart1) 6 a.m. – 9 p.m. EST, Monday - Fri or request an date online.

Department of Cardiovascular Medicine : Heart valve specialists in the following sections provide evaluation, medical management and life-long care of patients with heart valve disease:

• Section of Cardiovascular Imaging
• Department of Clinical Cardiology

Call Cardiology Appointments at toll-gratuitous 800.223.2273, extension 4-6697 or request an date online.

Considering traveling to Cleveland Clinic for eye surgery?

If yous demand a middle operation, you want the best surgeon with the all-time team at the best infirmary. But traveling to the nation'south best infirmary for heart surgery is more comfortable and convenient than yous might think.

• Learn more than about traveling for heart surgery

Need a 2d opinion?

Virtual 2d Opinions connect you online with top Cleveland Clinic specialists who can review your diagnosis and offer boosted consultation, speedily and deeply.

Contact

To obtain a surgical consultation, or if you have additional questions or need more information, click hither to contact u.s.a., conversation online with a nurse or phone call the Miller Family Eye, Vascular & Thoracic Plant Resource & Information Nurse at 216.445.9288 or price-free at 866.289.6911. We would be happy to help you.

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Diagnostic tests are used to diagnose your valve affliction and the most effective treatment method.

• Diagnostic testing

Anatomy

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Surgical Outcomes

Why choose Cleveland Dispensary for your intendance?

Our outcomes speak for themselves. Please review our facts and figures and if you take any questions don't hesitate to ask.

Source: https://my.clevelandclinic.org/health/treatments/17240-mitral-valve-repair#:~:text=What%20is%20the%20durability%20of,annually%20to%20assess%20valve%20function.

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