How Long Does It Take To Recover From Mitral Valve Repair

Overview

Mitral Valve Repair at Cleveland Clinic

At Cleveland Dispensary we have the world's greatest feel with mitral valve repair, the best option for nigh patients with a leaking mitral valve (mitral regurgitation).

Our surgeons have special expertise in mitral valve repair. As a outcome, at Cleveland Clinic, about all leaking mitral valves are repaired rather than replaced. A repair rate of nearly 100% for patients with leaking mitral valves provides patients with ideal outcomes. And for those with isolated mitral valve problems, the bulk of operations are performed robotically or minimally invasively, ensuring rapid recovery.

In 2022, patients traveled to Cleveland Clinic from all 50 states and 103 countries for their cardiovascular care.

What are the symptoms of a leaking mitral valve?

Many patients with mitral valve illness are asymptomatic (take no symptoms), even with a leak that is severe. When symptoms develop, they include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations (extra or skipped centre beats).

How is a leaky mitral valve diagnosed?

The first step involves listening with a stethoscope. Using a stethoscope, the doctor hears a murmur, which represents turbulent claret flow across an abnormal valve. The diagnosis is confirmed by an echocardiogram. Ultrasound is used in an echocardiogram to allow the doctor to visualize the heart valves and determine the severity and cause of the leak. In most patients, a standard transthoracic echocardiogram (a probe placed on the skin of the chest) is adequate to visualize the valve. Sometimes a transesophageal echocardiogram (a probe passed through the oral cavity into the esophagus) is necessary to more than closely visualize the valve; this is an outpatient procedure.

What is mitral valve prolapse?

Mitral valve prolapse is a common condition in which the mitral valve leaflets are floppy or loose. Mitral valve prolapse is diagnosed past echocardiography. Most patients with mitral valve prolapse do not have a leaky valve and do non require surgery. When a valve with prolapse has a severe leak, surgery should exist considered.

Mitral Valve Prolapse

What are the indications for surgical repair of a leaking mitral valve?

Surgery should exist considered when the leak is severe. In most facilities, the regurgitation (leak) is graded on a calibration from 0 to four, with 0 existence no leak and iv being a severe leak.

Surgery should be considered in about all patients with a leak that is graded as a iv (severe) and in some patients with a leak that is graded as a 3 (moderately astringent). When a patient with mitral regurgitation develops symptoms, a subtract in heart function, or an increase in heart size, surgery is nearly ever recommended. Surgery should too exist considered when a patient develops atrial fibrillation, which is an irregular heartbeat. Surgery is also recommended in most asymptomatic patients who accept a severe leak. In asymptomatic patients with severe mitral regurgitation, surgery improves long-term survival. In contrast, waiting for the evolution of symptoms or changes in heart function tin leave patients with permanent eye damage.

What is the take chances that a leaky mitral valve can exist repaired?

Nearly 100%. The most mutual cause of mitral regurgitation is a condition called degenerative mitral valve disease—this is also called mitral valve prolapse, myxomatous mitral valve disease, and a floppy mitral valve. Such valves can be repaired (rather than replaced) in more than 95% of patients. Cleveland Clinic heart surgeons have the globe's largest experience with mitral valve repair.

What is the chance that a leaky mitral valve tin can exist repaired minimally invasively?

Approximately threescore-80%. When a patient requires isolated mitral valve surgery for a degenerative valve, at Cleveland Clinic nosotros can perform the functioning through a two to four inch skin incision in in the majority of cases. Preoperative testing enables us to cull the safest approach for each patient. We offering several different minimally invasive approaches, including a small incision on the right chest, a small-scale incision in the mid-line, and robotically assisted procedures. Expertise with several approaches enables us to decide the best procedure for each patient, optimizing results.

Process Details

Minimally Invasive Mitral Valve Repair

Cleveland Clinic surgeons are pioneers in the development of minimally invasive techniques for mitral valve repair. Today, the majority of isolated mitral valve repairs tin be performed through a 2-3 inch incision on the right side of the chest. In many cases, we can apply the surgical robot and limit incision size to 1 inch.

Full Sternotomy

Partial Sternotomy

Correct Thoracotomy

Robotic

Several minimally invasive approaches are available to patients. Minimally invasive approaches may also be used for patients who require aortic valve or tricuspid valve surgery, alone or in combination with mitral valve surgery. In addition, Cleveland Clinic is a leader in percutaneous (through the skin) approaches to mitral valve repair, which may lead to additional treatment options in the time to come.

Advantages of minimally invasive approaches include faster recovery, less pain, reduced need for blood transfusion and amend corrective outcome. We evaluate each patient for robotic and minimally invasive surgery and work with the patient to choose the all-time and safest approach in each example.

Learn about minimally invasive mitral valve repair: types of incisions, surgical options, photos and videos.

Mitral Valve Repair Surgery — Surgical Techniques

Cleveland Clinic surgeons have been instrumental in the evolution and awarding of modern mitral valve repair techniques. Bug with the posterior leaflet are generally corrected by a small series of chords or a small-scale resection of the abnormal portion of the valve. Anterior leaflet dysfunction is managed by creation of new chords or chordal transfer. Anterior leaflet repair techniques are technically challenging, requiring a skilled and experienced surgical squad to achieve the best result. All repairs include an annuloplasty, which is a complete or partial ring placed around the circumference (rim) of the valve.

Mitral Valve Posterior Leaflet Prolapse — Valve Repair Surgery

During mitral valve repair heart surgery, triangular resection is the technique used most frequently for posterior leaflet prolapse.

Triangular Resection Mitral Valve Repair

Ruptured chords at free edge of posterior leaflet. Region to be resected is indicated.

Abnormal segment has been removed. Leaflet edges are sewn together.

Annuloplasty completes the repair.

Mitral Valve Anterior Leaflet Prolapse — Valve Repair Surgery

When there is mitral valve prolapse of the anterior leaflet, repair is more circuitous and requires greater surgical expertise. To correct anterior leaflet prolapse caused by a ruptured or elongated chord, we usually create new chords out of Gore-Tex. These Gore-Tex chords mostly terminal forever. A second technique used for correction of anterior leaflet prolapse is chordal transfer, which involves transfer of chords from another function of the valve to the area with abnormal chords. Both techniques provide fantabulous long-term results for patients.

Gore-Tex® Chord for Correction of Inductive Leaflet Prolapse

Ruptured Chord

After Chordal Repair

Chordae may exist constructed from Gore-Tex® sutures. A Gore-Tex® suture is affixed to the head of the papillary musculus and then passed through the free border of the unsupported anterior leaflet, providing support.

Long-term durability is excellent. The new chordae practise not rupture or elongate.

Chordal Transfer to Care for Anterior Leaflet Prolapse

Chordal transfer to correct inductive leaflet prolapse.

Posterior leaflet chordae are transferred to the unsupported costless edge of the inductive leaflet. The posterior leaflet is then repaired. A cloth annuloplasty band completes the repair.

Mitral Valve Repair — Special Situations

Mitral Valve Repair and Atrial Fibrillation

Many patients with mitral valve disease have atrial fibrillation, (an abnormal heart rhythm.) For these patients, at the time of mitral valve repair, Cleveland Clinic surgeons perform an ablation (Maze process) with the intent of curing the atrial fibrillation. In some patients with atrial fibrillation, a sternotomy (standard) arroyo may provide the all-time results.

Previous Mitral Valve Repair with Recurrent Mitral Regurgitation

In rare instances, a mitral valve repair may fail over time. While most surgeons replace such valves, Cleveland Clinic surgeons tin frequently re-repair these valves, offer fantabulous long-term durability and the of import advantages that become with mitral valve repair.

Previous Heart Surgery with Recurrent Mitral Regurgitation

Occasionally, a patient who has had previous bypass surgery, aortic valve surgery or other centre surgery develops a new problem with the mitral valve. In these re-operative settings, Cleveland Dispensary surgeons tin can safely and effectively repair nearly all leaking mitral valves.

Mitral Valve Repair for Endocarditis

When infection damages a mitral valve (endocarditis), repair is peculiarly challenging. Because of their extensive experience with such patients, Cleveland Clinic surgeons successfully repair the mitral valve in the bulk of patients who have had endocarditis.

Mitral Calcification

Occasionally, a patient with mitral regurgitation has all-encompassing calcium deposits on the valve leaflets or annulus. The calcium makes repair difficult and requires application of advanced surgical techniques and sound judgment. Cleveland Clinic surgeons accept the expertise to ensure first-class outcomes in patients with calcified mitral valves.

Mitral Valve Repair in Women with Breast Implants

We tin commonly perform a minimally invasive approach in women with chest implants. Working with a plastic surgeon, nosotros remove the right breast implant through a minor, corrective incision We then repair the mitral valve through the same incision. The plastic surgeon and then replaces the breast implant, often upgrading to a newer implant.

Risks / Benefits

Your Center Valves

Advantages of Mitral Valve Repair: Why Repair Is Improve Than Replacement

Mitral valve repair is the all-time pick for about all patients with a leaking (regurgitant) mitral valve and for many with a narrowed (stenotic) mitral valve.

Compared to valve replacement, mitral valve repair provides better long-term survival, ameliorate preservation of heart part, lower risk of complications, and usually eliminates the need for long-term use of blood thinners (anticoagulants). For these reasons, Cleveland Clinic surgeons are committed to mitral valve repair, when possible.

Advantages of Mitral Valve Repair:

• Better early and late survival (Longer life!)
• Improved lifestyle
• Better preservation of heart function
• Lower run a risk of stroke and infection (endocarditis)
• No demand for claret thinners (anticoagulation)

Your Mitral Valve

Mitral Valve Chordae and Papillary Muscles

What is the risk of mitral valve surgery?

For asymptomatic patients having mitral valve repair, the operative risk is approximately 1 in 1000. Risk in symptomatic patients remains well under 1%. The presence of coronary artery illness or other weather condition that crave surgical treatment will bear on your individual take a chance. Inquire your doctor most your surgical chance.

What is the durability of a mitral valve repair?

After mitral valve repair, 95% of patients are free of reoperation at ten years, and this figure is approximately 90% at 20 years. Thus, reoperation is uncommon after a successful mitral valve repair. An echocardiogram is recommended annually to assess valve function. In addition, patients who had valve surgery must take steps to prevent infection and reduce the hazard of endocarditis (an infection of the valve).

Why is it important to have my surgery at a center with a big experience in mitral valve repair?

Mitral valve repair is the best choice for nearly all patients with a leaking (regurgitant) mitral valve and for many with a narrowed (stenotic) mitral valve.Compared to valve replacement, mitral valve repair provides better long-term survival, better preservation of heart function, lower hazard of complications, and usually avoids the demand for long-term use of blood thinners (anticoagulation). For these reasons, Cleveland Clinic surgeons are committed to mitral valve repair.

Advantages of Mitral Valve Repair

• Meliorate early and belatedly survival
• Improved lifestyle
• Better preservation of heart part
• Lower take a chance of stroke and infection (endocarditis)
• No need for claret thinners (anticoagulation)

Mitral valve repair is more challenging than mitral valve replacement, and experienced surgeons are more likely to be able to repair the valve and ensure an excellent outcome.

Resources

Doctors who care for

Cleveland Clinic has the nation'south largest valve treatment program.

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality go and the more they affair.

Clearly, the doc and hospital that you cull for complex, specialized medical care will take a directly bear upon on how well you lot do. To help you make this choice, delight review our Miller Family Heart, Vascular & Thoracic Constitute Outcomes.

Cleveland Dispensary Centre, Vascular & Thoracic Establish Cardiologists and Surgeons

• Valve Centre
• Endocarditis Center
• Mitral and Tricuspid Valve Center

The post-obit Mitral Valve Heart surgeons specialize in mitral valve surgery:

• Marc Gillinov, Dr.* Department Chairman, Thoracic and Cardiovascular Surgery
• Daniel Burns, MD*
• Kenneth McCurry, Md

*Performs robotically assisted mitral valve surgery

The Mitral and Tricuspid Valve Eye surgeons offers expertise and experience to provide the best outcomes possible.

Departments and Sections:

Choosing a doctor to treat your heart valve affliction depends on where you lot are in your diagnosis and handling. The following Heart, Vascular & Thoracic Constitute Sections and Departments treat patients with Heart Valve Disease:

Department of Thoracic and Cardiovascular Surgery : Surgeons in the Department of Thoracic and Cardiovascular Surgery are experts in the treatment of valve disease, including valve repair or replacement, minimally invasive middle valve surgery, and re-practise operations depending on the individual needs of the patient. For surgical review or more information, telephone call toll-gratis 877.843.2781 (877-8Heart1) 6 a.m. – ix p.k. EST, Monday - Friday or request an engagement online.

Section of Cardiovascular Medicine : Eye valve specialists in the following sections provide evaluation, medical direction and life-long care of patients with heart valve disease:

• Department of Cardiovascular Imaging
• Section of Clinical Cardiology

Call Cardiology Appointments at toll-costless 800.223.2273, extension 4-6697 or request an engagement online.

Considering traveling to Cleveland Clinic for heart surgery?

If you need a heart performance, y'all want the all-time surgeon with the best squad at the best hospital. Simply traveling to the nation's all-time hospital for heart surgery is more comfortable and convenient than you might think.

• Learn more about traveling for middle surgery

Need a 2d opinion?

Virtual Second Opinions connect you online with top Cleveland Dispensary specialists who can review your diagnosis and offer boosted consultation, rapidly and securely.

Contact

To obtain a surgical consultation, or if you lot accept additional questions or demand more information, click here to contact us, chat online with a nurse or call the Miller Family unit Heart, Vascular & Thoracic Establish Resource & Information Nurse at 216.445.9288 or price-gratis at 866.289.6911. Nosotros would exist happy to aid you.

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Why cull Cleveland Clinic for your care?

Our outcomes speak for themselves. Delight review our facts and figures and if y'all have whatever questions don't hesitate to ask.

How Long Does It Take To Recover From Mitral Valve Repair,

Source: https://my.clevelandclinic.org/health/treatments/17240-mitral-valve-repair

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