Mitral Valve Repair/Replacement Surgery
The mitral valve is the "inflow valve" for the left ventricle, the heart’s main pumping chamber. Blood flows from the lungs, where it picks up oxygen, into the left atrium and then through the open mitral valve into the left ventricle. When the ventricle contracts to push blood out to the rest of the body, the two leaflets of the mitral valve close to prevent blood from leaking back into the lungs.
A damaged mitral valve may leak if the leaflets do not close properly (mitral regurgitation or insufficiency), or the valve opening may become narrowed (mitral stenosis). When the mitral valve does not function properly, blood can not move through your heart to the rest of your body efficiently and can ultimately cause blood to back up into the lungs. Damage to the mitral valve can result from a congenital defect (abnormal from birth), the natural process of aging, infection, or from coronary artery disease. Symptoms include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations (extra or skipped heart beats). In addition to significant respiratory symptoms, a damaged mitral valve can eventually lead to congestive heart failure. Therefore the valve may need to be repaired or replaced.
Both valve repair and replacement are open-heart surgeries. If the valve can not be repaired, it is replaced with either a biological or mechanical valve (see below). Each artificial valve has its own distinct advantages and disadvantages. The advantage of mechanical valves is their durability. The disadvantage of mechanical valves is that they require anticoagulation (blood thinners) for life to prevent blood clots. Biological valves have a lesser risk of blood clots and typically require only the temporary use of anticoagulates. However, biological valves have reduced durability and will eventually wear out.
Talk to your cardiologist and cardiothoracic surgeon to discuss your individual needs and to best determine your individual risk, which will depend on your age, specific medical conditions, and your heart function.