MITRAL VALVE REPAIR

Mitral valve is one of the four heart valves and it controls the entrance of oxygenated blood from the lungs into the heart. Rheumatic heart disease, myxomatous degeneration, and valve infections may lead to disturbances in the valve function. Mitral stenosis results from limitation of valve leaflet excursion and mitral regurgitation (insufficiency) will results if there is incomplete apposition of the valve leaflets.

Mitral valve replacement has been the only treatment option for mitral valve pathology for a long time. However, mitral valve repair is being used increasingly for mitral valve disorders especially in the United States. The patients’ valve is preserved and life long Coumadin (blood thinner) administration can be avoided. 

Mitral valve repair has a significant impact on the lives of younger patients (30-50 age) in whom mitral valve pathology is increasingly recognized. A valve replacement at this age would put the patient at risk of Coumadin related complications and subject the patient to the possible complications of an artificial valve for many years to come. Since the risk of artificial valve complications (blood clots, infection and calcification for biological valves) and complications of blood thinners (bleeding and blood clots) are expressed in the number of years patient has to carry the artificial valve, younger patients are inherently more exposed to these risks due to the longer expected life span. It is also well known that mitral valve repair patients have better preserved heart functions and much decreased risk of early postoperative complications (heart failure, hospital stay and death) compared to the patients whose valves are replaced. 

Mitral valve repair is being used for a variety of valve pathology however the most common indications are degenerative and rheumatic valve pathology. Mitral valve repair has also been used for patients with mitral stenosis (valve narrowing) albeit with less frequency.

Mitral valve repair techniques have evolved over the years and long term results have been encouraging. It is now possible to repair about 90% of incompetent (leaking mitral valves) mitral valves using a variety of novel techniques that have been developed and perfected over the last 20 years. This surgery has excellent long term results when it is done for correct indications and when performed by expert surgical teams.

Studies have shown that the chance of repairing a valve is directly proportional to the experience of the surgeon and his/her familiarity with various repair techniques. Therefore it is important to ask your surgeon about his/her experience with mitral valve repair techniques and the number of these procedures he/she has performed as well as his long term results. 

Dr. Gurbuz learned mitral valve repair techniques from Prof. Dr. Albert Starr in the United States. He has personally performed over 300 mitral valve repairs in the last 10 years with excellent outcomes and long term follow-up.