Mitral Valve Repair and Replacement Surgery- Why is it done?

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Mitral valve repair and replacement are heart surgery procedures used to repair or replace a leaky or stiff mitral valve. The mitral valve connects the left and right heart chambers (the left atrium and the left ventricle).

Mitral valve replacement and repair is an open-heart surgery operation or a minimally invasive heart surgery procedure. Sometimes, a catheter-based approach can be used to repair a mitral valve problem. The exact approach used is decided by the extent of the mitral valve disease and whether it is worsening or not.

Mitral valves can break down in two ways:

Regurgitation: Regurgitation occurs when the flaps (leaflets) of the mitral valve do not shut tightly, allowing blood to leak backward. Patients with a prolapsed mitral valve frequently experience mitral valve regurgitation. As per the heart surgeon at Sir Ganga Ram Hospital Dr. Sujay Shad, who has performed many successful surgeries for Mitral Valve Repair in India, if a person has severe mitral valve regurgitation symptoms, he or she should consider having mitral valve repair surgery.

Stenosis: Stenosis occurs when a valve fails to open properly or narrows, preventing blood from flowing out of the heart chambers. When it happens, the heart is forced to use more energy to push blood through the stiff (stenotic) valve.

When mitral valves fail to open and shut properly, the heart can be harmed. One cause of heart failure is an issue with the heart valves.  

Patients Should Be Aware of the Following Information on Heart Valve Problem:

The patient can expect to live a long, active, and healthy life at first, if their surgery is successful and concern is addressed at the initial stage.

A comprehensive echocardiography (heart ultrasound) can determine the heart valve problem, its severity, and any heart issues. When deciding on a treatment approach, patient symptoms, valve disease, and the consequences for the heart all must coincide and are explained by one another. Many patients do not require surgery for several years, and during this time, some young women can be advised to start family planning.

Some individuals with mild or severe heart valve disease may be kept under monitoring using echocardiography, other diagnostics, and a routine physical examination. These examinations are typically required every one to two years, with the exception that the patient may be evaluated sooner if necessary.

Commonly prescribed medications can alleviate symptoms, slow disease progression, and improve quality of life. When a patient's symptoms do not improve despite medical treatment and an echo or other test shows a near-term risk of worsening or deterioration, surgery becomes necessary.

Surgery for Heart Valve Disease

With proper planning and evaluation, the vast majority of heart valve disease patients can have safe heart valve surgery. The majority of patients can expect a risk of less than 2% for such treatments.

Heart Surgery Doctor in Delhi, Dr. Sujay Shad, considers a variety of factors before recommending a heart valve operation, including the patient's age, the type of heart valve disease, heart function, the effects of back pressure on the lungs or other heart chambers, the health of the other organs, overall health, steroid use, and so on.

Mitral valve repair is a common surgery, and there are tried-and-true surgical ways of doing so. Aortic valve repair has witnessed a rise in demand over the past five years. The main benefit of heart valve repair surgery is that a significant portion of native tissues are maintained, preserving the heart's basic structural integrity.

Natural surfaces also imply that the patient will not need long-term blood-thinning medication after the repair. Patients' longevity improved following mitral valve replacement.  

Valve Replacement

Heart valve replacement is a popular procedure for individuals who have heart valve dysfunction. Before placing either a mechanical heart valve or a biological heart valve (bioprosthesis), the surgeon usually removes the entire heart valve for replacement. This is the rule that the aortic valve replacement method follows.

Aortic root augmentation surgery is required when a patient with aortic valve disease has a very narrow hole for a large replacement heart valve.

The chordae, or heart valve structures, must be retained to the greatest extent possible for mitral valve replacements. Patients suffering from aortic and mitral valve disease may require double valve replacement or repair. Furthermore, triple valve surgery, known as double valve replacement and tricuspid repair, is frequently done to treat patients with tricuspid valve illness.

When performing heart valve surgery on patients, doctors usually find considerable additional disease in the coronary arteries that must be treated concurrently with 1–4 bypass grafts.

Heart Valve Replacement Procedure

While the patient is fully unconscious, a heart valve replacement is performed. To perform surgeries, either a full sternal division with an incision in the centre of the chest or minimally invasive treatments are performed. There are several obvious advantages if the surgeon decides minimally invasive heart surgery is a safe option for the patient.

To do heart valve surgery safely, the body must be supplied with blood, oxygen, and nutrition by a machine (a heart-lung machine) while the surgeon operates on an inactive heart.

Through an appropriate incision in the relevant area of the heart, the surgeon will approach the diseased valve, remove it, and replace it with a valve of the proper size and type. The cardiac structures are restored by the end of the procedure, and the heart is allowed to resume beating. Once the patient's heart begins to beat properly, the heart-lung machine is removed. The patient is returned to critical care or recovery after the chest has been sealed.  

Things to Know!

Heart valve surgery has improved significantly over the last three decades and is almost painless now. Today, enhanced tools, valves, repair materials, surgical and anesthetic procedures, risk factor management, and more effective drugs are all readily available. The majority of patients continue to benefit considerably, even 15 to 20 years after surgery.

All patients are provided medical attention in an intensive care unit for the first two days after surgery. A specialist cardiac surgery postoperative care nurse stays with the patient around the clock. The team of experts at Sir Ganga Ram Hospital monitors every vital sign, including the pulse, blood pressure, varying pressures inside the heart chambers, and lung function, regardless of whether the patient is breathing mechanically or organically. Kidney, liver, and brain functions are also examined, as is the need for intravenous fluids and blood transfusions.

If one wants more details, one can contact Dr. Sujay Shad, a senior heart surgeon at Sir Ganga Ram Hospital.

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