Mitral Valve Repair

mitral valve

In case of mitral valve regurgitation, repair is generally considered a better alternative than the valve replacement. Here we shall illustrate the methods of heart valve surgery, with emphasis on the advantages of minimally invasive mitral valve heart surgery in India, Mexico, Turkey & other international cardiac surgery centers.

What could go wrong with the Mitral Valve?

In a normal heart, blood flows from the left atrium through the mitral valve into the left ventricle. The blood is then pumped out of the left ventricle and circulated through the body’s blood vessels. When this happens, the two halves (leaflets or cusps) of the mitral valve close to prevent blood from being pushed back into the left atrium.

The possible complications with the Mitral Valve are:

Mitral valve stenosis:

The mitral valve thickens and narrows. Hence, the valve cannot open completely, causing an obstruction in the flow of blood.

Mitral regurgitation:

The valve does not shut tight and hence blood flows back into the left atrium when the left ventricle contracts to push the blood out.

Mitral valve prolapse:

The two halves or leaflets of the mitral valve are bulging and they do not close properly. They flop backwards and cause a clicking or murmuring sound (heart murmur). This also causes the mitral valve to leak and blood flows back into the left atrium. Mitral valve prolapse can be a congenital defect or develop later on. In either case, the cause is not known.

In all the above three conditions the functioning of the heart and its capacity to pump blood through the body will be affected. This will force the heart to work harder. Symptoms of mitral valve malfunction range from fatigue and breathlessness to even vomiting blood. Mitral valve prolapse is a fairly common condition, and most people with this condition live with no discomfort or symptoms. But in some cases, stress on the flopping valve halves can cause other problems that need to be treated.

Mitral Valve Repair vis-a-vis Mitral Valve Replacement

The conventional way of mitral or left atrioventricular valve surgery was to replace the valve. However, it is now generally agreed that where possible the valve should be repaired and not replaced.

In mitral valve replacement, an artificial mitral valve replaces the native valve. Two kinds of prosthetic heart valves are available.

Mechanical valves

are created from manmade materials. Though these valves last long, patients are required to take anti-coagulant medication to prevent blood clots on or around the valve.

Biological (tissue) valves

are taken from pig, cow, or human donors. Biological valves don’t last as long as mechanical valves. However, when biological valves are used, long-term therapy with anticoagulant medication often isn’t necessary.

When compared to replacement, bicuspid valve repair has certain advantages of letting the native heart function better, better patient recovery, and no need for blood thinners. Mitral heart valve repair research has also shown that in mitral valve repair patients, a second operation is usually not necessary. The 2006 guidelines from the American Heart Association and the American College of Cardiology state that “mitral valve repair is recommended over mitral valve replacement in the majority of patients with severe chronic mitral regurgitation who require surgery.” However, not all damaged valves are suitable for repair; in some, the state of valve disease is too advanced and replacement is necessary.

Traditionally, valve repair was done through sternotomy, that is, open heart surgery. But advances in medical science have brought about alternative approaches to mitral valve repair like minimally invasive mitral valve repair and – going one more step ahead – minimally invasive port access technique for mitral valve surgery.

Minimally Invasive Mitral Valve Repair and its Benefits

Minimally invasive mitral valve repair is performed through a two-inch keyhole incision on the side of the chest. The port access technique is a step ahead in that the incision is even smaller and the whole operation is video-directed, whereas in non-port access minimally invasive mitral valve surgery, the operation is done by direct vision. The minimally invasive approaches avoid an incision in the breastbone (sternotomy) and have several benefits like:

  • Less pain
  • Shorter stay in hospital. Hence, patients return to work and everyday activity sooner after surgery.
  • Less bleeding
  • Fewer chances of infection as the incision is smaller; and
  • Cosmetic benefits

Mitral Valve Repair Surgeons & Hospitals in India

India has gained a name for high tech medical surgeries & it is now quite common for many in the west to consider mitral valve prolapse repair in India. Many of the surgeon have returned to India from training in leading centers in the USA & UK.

India’s leading cardiologists and cardo-thoracic surgeons combined with adoption of the latest technology have given it the edge over other competing medical tourism destinations in case of heart surgeries. Of course, needless to say, it is also the most affordable.

With skyrocketing costs of medical care in the US, going abroad for heart surgery is becoming very common. The cost of mitral valve repair in the US can be anywhere between $40,000–$200,000. The same procedure in India can be done for about $10,000.

If this raises eyebrows about the quality of health care in India, consider that medical tourism in India is a multi-million dollar industry and is growing at the rate of 25%. Many medical tourism hospitals & surgery centers in India are either already accredited or are going for accreditation from Joint Commission International (JCI), the global arm of the institution that screens US hospitals. But while choosing a hospital in India for mitral valve repair, exercise caution and consider only the best. There may be other hospitals that offer more discounts than the best ones, but they are not advisable. Please remember that mitral valve repair can be done only by highly skilled cardiac surgeons. Hence, be doubly sure about the credentials of your hospital and cardiac surgeon in India.

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