MITRAL VALVE

Background

The heart has 4 valves that regulate the flow of blood.  These include the aortic, mitral, tricuspid, and pulmonic valve.  Valves are designed so that blood travels in one direction.  Valves prevent the backward flow of blood.  There are 2 things that can go wrong with valves:

 

  1. They can narrow and get tight.  The medical term for this is “stenosis”

  2. Or valves can become leaky and blood flows backward.  This is called “regurgitation”

 

Mitral valve disease is one of the most common valvular heart diseases in the world, yet it is still undertreated.  Patients with severe mitral regurgitation and comorbidities survive only 2.6 years without correction.  Intervention can improve survival.

 

In patients with mitral regurgitation, some of the blood leaks back into the heart and lungs.  The heart has to work harder to get blood to the body and with time, the heart begins to fail.  Common symptoms of mitral regurgitation include:

  • Fatigue

  • Shortness of breath

  • Arrhythmias or atrial fibrillation

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Diagnosis

Click the link below to learn more about treatment options for mitral regurgitation:

The most common ways of diagnosing mitral regurgitation are by either listening to the heart with a stethoscope or by performing an ultrasound of the heart.

Here’s what mitral regurgitation sounds like with a stethoscope: >

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MitraClip

A tiny clip is delivered through the groin to repair the malfunctioning mitral valve without having to open the chest (i.e. sternotomy).

Here’s a video of a MitraClip through the groin:

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Traditional Open Heart Surgery

The chest is opened (i.e. sternotomy) with direct access to the mitral valve. 

Here’s a video of a traditional mitral valve surgery through a sternotomy:

 
Treatment Options

Many patients are often unaware that they have mitral regurgitation.  Even in patients that don’t have symptoms, the ACC and AHA recommends surgery in patients with severe mitral regurgitation if there is a good chance that the valve can be repaired.  The reason is that with time, the heart will only get worse and it’s better to intervene sooner than later.


Fortunately, there are a lot of good treatment options.  Your doctor can determine which is the best option.

Minimally Invasive Mitral Valve Surgery 

A small 5cm incision is made on the right chest with direct access to the mitral valve without having to open the chest (i.e. sternotomy).  Advantages include reduced surgical trauma, less blood loss, less chance of infection, and faster recovery.

This video shows a minimally invasive mitral valve repair performed by Dr. Tom C. Nguyen (posted with patient permission)

Mitral valve repair remains the gold-standard for treating patients with primary mitral regurgitation.  It is important to ask your surgeon if she/he has experience with performing minimally invasive valve surgery and how many cases she/he does per year.  Experience with the mitral valve is important to make sure patients get the best outcomes.  

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MitraClip

A tiny clip is delivered through the groin to repair the malfunctioning mitral valve without having to open the chest (i.e. sternotomy).

Here’s a video of a MitraClip through the groin:

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Traditional Open Heart Surgery

The chest is opened (i.e. sternotomy) with direct access to the mitral valve. 

Here’s a video of a traditional mitral valve surgery through a sternotomy:

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Email: tuyen.nguyen@uth.tmc.edu

© 2020 Dr. Tom C. Nguyen, MD

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MINIMALLY INVASIVE VALVE SURGERY

Minimally Invasive Aortic and Mitral Surgery, TAVR and MitraClip