Mitral Valve Surgery vs. Valve Replacement

The mitral valve is a one-way valve deep inside your heart that connects the left atrium to the left ventricle. The mitral valve acts as the door between the upper and lower left chambers of the heart. When the mitral valve is damaged or diseased, it may affect the heart’s ability to function efficiently, preventing normal blood flow from the heart out to the body. Our skilled heart specialists have years of experience managing these conditions and will discuss your treatment options with you.

Mitral Valve Disorders: Expert Care in Virginia

The mitral valve is the most commonly repaired heart valve. Two major disorders cause most of the problems:

  • Mitral valve prolapse, or regurgitation, occurs when the valve leaflets (or doors) don't close properly, allowing blood to flow backward into the left atrium. This is the most common ailment of heart valves, affecting men and women equally. It is also called floppy valve syndrome.
  • Mitral valve stenosis is marked by a narrowed valve opening. This makes your heart have to work harder, often unsuccessfully, just to pump the same amount of blood to your body. Mitral valve stenosis affects women twice as often as men.

You may not experience any symptoms with a mitral valve disorder. Your physician may be the first to know you have a problem. The doctor may detect a clicking sound or irregular heartbeat when listening to your chest with a stethoscope.

Mitral Valve Disorders Treatment

Your doctor may first try to treat your mitral valve disorder with medication. We may also recommend a minimally invasive procedure called a balloon valvuloplasty, which opens the valve passage. If those treatment options are not sufficient, we will most likely recommend surgery.

There are two surgical options for treating mitral valve disorders:

  • Mitral valve repair
  • Mitral valve replacement

Your surgeon will first try to repair the valve through minimally invasive heart surgery. If that is not possible, we will perform a valve replacement, also using minimally invasive techniques. Your surgeon will discuss with you the benefits of repair vs. replacement, as well as the differences in the different types of valves. Learn more about valve repair vs. valve replacement.

Mitral Valve Surgery: Minimally Invasive Techniques

Sentara heart surgeons perform mitral valve repair and replacements using minimally invasive surgical techniques. Physicians use sophisticated instruments and a tiny camera to operate in much smaller spaces. Benefits of a minimally invasive procedure include:

  • Smaller incisions
  • Fewer incisions
  • Less pain and bleeding
  • Quicker recovery for patients

Learn more about minimally invasive heart surgery at Sentara.

Why treat mitral valve problems?

While you may not realize at first that you have a mitral valve problem, experience shows the symptoms will become progressively worse.
A heart that can’t pump blood efficiently leads to congestive heart failure if left untreated. Here’s what happens:

  • The heart enlarges, trying to move more fluid, but it backs up into the heart and puts pressure on the lungs.
  • This strain on the heart makes it weaker and less efficient at supplying your body with needed oxygen and nutrients that are carried in the blood. It also threatens other major organs in your body.
  • The blood pools in the left atrium, increasing the chance of blood clots in the heart. If the clots break loose and travel throughout the body, they may cause a stroke (in the brain) or a heart attack.
  • You may also experience irregular heartbeat, or atrial fibrillation, a pounding sensation where the heart beats erratically.
  • The excess blood in the heart can back up into the lungs, causing pulmonary edema or lung congestion.

Types of Mitral Valve Repair Procedures

Minimally invasive heart surgery is easier on the patient. When treating mitral valve stenosis, surgeons prefer mitral valve repair instead of replacement, because it:

  • Preserves the valve and left ventricular function
  • Eliminates the risks of mechanical valve and the need for lifelong anti-coagulants

There are three types of repairs:

  • Commissurotomy: The edges of the valve leaflets, which form the opening for the valve, are fused partially together, restricting blood flow. The surgeon snips these apart.
  • Resection: The surgeon surgically reshapes the valve opening to restore its function or to remove extra tissue that causes leakage.
  • Annulus support: If the valve is too wide or too floppy, your surgeon sews a soft, sturdy ring around the valve to tighten the opening and give it extra support.

If the valve cannot be repaired, your surgeon will discuss valve replacement with you.

Recovery from Mitral Valve Surgery

On average, patients who have had minimally invasive heart surgery with no complications are in the hospital for four days. In comparison, the average stay after a full, open-chest surgery is five to seven days.

The process of healing from even small incisions may make you uncomfortable at first. Talk to your doctor or nurses if you think medication will be helpful. They can also recommend alternative pain relief remedies, such as warm compresses.