Mitral Valve Repair

The cardiovascular specialists affiliated with Memorial Hermann Health System treat a full range of heart and vascular conditions. We are dedicated to delivering the best possible outcomes by using a patient-centered, comprehensive approach.

If you have heart-valve disease affecting the mitral valve, a valve repair may be an appropriate treatment option. Today, specialists use both minimally invasive techniques as well as traditional open-heart surgery to repair problems with the mitral valve.

In addition to traditional surgical procedures, Memorial Hermann offers minimally invasive mitral valve repair with MitraClip®. We are the only hospital in Houston, and one of three in Texas, chosen to participate in the nationwide Endovascular Edge-to-Edge Repair study, or EVEREST II, that investigates the minimally invasive MitraClip® Cardiovascular Valve Repair System for the treatment of mitral valve regurgitation.

What is Mitral Valve Repair?

The mitral valve is located between the two left chambers of the heart: the left atrium and the left ventricle. Its job is to keep blood moving in the correct direction. When the valve does not open or close properly, the heart may become damaged, and you may need to have the mitral valve repaired.

Mitral valve repair can be performed as a minimally invasive surgical procedure, or as an open-heart surgical procedure. Mitral valve repair is used to treat two different problems:

Regurgitation: The mitral valve does not close completely. When this happens, blood will flow backward (instead of forward) through the mitral valve.

Stenosis: The mitral valve does not open properly or becomes too narrow. When this happens, blood cannot flow out of the heart chambers at the normal rate, and the heart has to work harder to pump blood.

The decision to repair or replace your mitral valve depends on the severity of your valvular heart disease. More serious conditions may require replacement, while patients with less severe disease may benefit from a repair procedure.

Sometimes the mitral valve cannot be effectively repaired. In these cases, your doctor may recommend valve replacement. During this surgical procedure, your mitral valve is removed and replaced with an artificial valve. There are two types of replacement valves:

Biological Tissue Valve

This type of valve is made from the heart tissue of cows or pigs. Biological valves will eventually need to be replaced.

Mechanical Valve

This artificial device is made of materials like carbon or titanium. Mechanical valves are durable and usually last for the patient’s entire life. You will need to take blood thinners, indefinitely, to prevent blood clots.

Types of Mitral Valve Repair

Several factors will determine the best type of valve repair for your specific condition. Cardiologists and surgeons affiliated with the Memorial Hermann Heart & Vascular Institute use the least aggressive approach, preserving heart valves whenever possible.

Open-Heart Valve Repair

Your surgeon will make a large incision in your chest and open your sternum or breastbone in order to reach the diseased mitral valve.

Minimally Invasive Valve Repair

Your surgeon will make small incisions in your chest and use long, thin instruments to reach the heart between your ribs, instead of going through the breastbone. Minimally invasive procedures may involve robot-assisted technology.

Nonsurgical MitraClip^®

Some patients with a high surgery risk may require nonsurgical treatment. The MitraClip® system involves inserting a tiny clip, through a catheter, into the heart to repair the mitral valve. The clip is inserted through the groin and does not involve incisions in the chest.

Valvuloplasty

This non-invasive procedure treats stenosis in the mitral valve. A special balloon is inserted into a narrowed valve and inflated to stretch and enlarge the valve.

Many patients with mitral valve disease do not have any symptoms. For patients with symptoms, repair surgery can improve problems like shortness of breath, fatigue and swelling of the feet and ankles.

There are many advantages to repairing the mitral valve, rather than replacing it. After a repair procedure, patients usually experience:

• Better heart function
• Improved long-term survival rates
• Lower risk of infection
• Lower risk of stroke
• No need to take blood thinners
• Better quality of life

Your experience will vary, based on which type of procedure you have. If you have open-heart surgery, you will most likely be placed on a machine that will breathe and circulate blood for you. While this machine is functioning, your heart will not beat or work on its own.

While you are under general anesthesia, your doctor may perform any of these repair functions:

• Close any holes in the mitral valve
• Remove any excess tissue so the valve can close completely
• Reconnect valve leaflets that have separated
• Separate valve leaflets that have fused together
• Repair chords that control the valve leaflets
• Reinforce the ring around the valve (annuloplasty)

Like all medical procedures, mitral valve repair has risks. It is possible to experience:

• Blood clots
• Bleeding
• Problems with heart rhythm
• Infection
• Stroke

Your length of your recovery will depend on whether you have open-heart or minimally invasive surgery.

Many patients spend some time in the intensive care unit (ICU) after surgery and then move to a regular hospital room. It is not unusual to spend about a week in the hospital.

Your doctor will work with you to develop a specific recovery plan and determine when you can safely resume your daily activities. You will be instructed to increase your level of activity slowly and gradually, as tolerated.

Once you have recovered, it is important to make healthy lifestyle choices like eating healthy foods, getting regular exercise, and avoiding alcohol and tobacco. It is also essential to schedule regular follow-up appointments with your doctor to monitor and manage your condition.

Some patients will be advised to attend cardiac rehabilitation. This is an exercise program to assist with your recovery and overall health after surgery.

If you have valvular heart disease, the affiliated physicians at the Memorial Hermann Heart & Vascular Institute can evaluate your condition and recommend a treatment plan. Our highly skilled practitioners utilize leading-edge technology to repair mitral valve conditions so you can get back to the life you enjoy.

To learn more about mitral valve repair, visit Find a Doctor to schedule an appointment.