The human heart is a pump which is responsible for circulating oxygenated blood around the body and returning deoxygenated blood to the lungs where carbon dioxide is exhaled and fresh oxygen is inhaled. The heart has four chambers: the left and right atria and the left and right ventricles. The heart muscle relaxes to allow blood to fill it and the blood is expelled from the chamber when the muscle contracts. The flow of blood backwards into a chamber is prevented by the presence of a natural one-way valve at the exit of the chamber: the valves of the heart. There are four valves in the heart: the mitral valve, the pulmonary valve, the aortic valve and the tricuspid valve. As a result of disease, congenital defect, heart attack or the natural aging process, the heart’s valves may suffer from stenosis or regurgitation and ultimately, the valves may need to be replaced surgically. This article looks at the mitral valve repair long term outcome following surgical intervention.
The Mitral Valve
The mitral valve prevents blood from flowing back (regurgitation) into the left atrium once it has been pumped into the left ventricle (from where it passes through the aortic valve into the aorta and takes oxygenated blood around the body). Unlike the other valves which contain three flaps, the mitral valve consists of two flaps. Stenosis of the mitral valve is a condition in which the valve becomes narrowed (either the valve itself or the tissue just above or below the valve) leading to problems efficiently ejecting blood from the chamber through the valve.
Open Heart Surgery and Outcome
The mitral valve can be repaired or replaced, depending upon its condition, in an open-heart procedure which typically takes between two to three hours to complete. Recovery from the initial surgical procedure requires a five to seven day period in hospital and then between four and eight weeks before the patient can resume their job. A full recovery should be achieved within three months of the surgical procedure.
The mitral valve long term outcome is usually better if the valve can be repaired rather than replaced, according to the Cleveland Clinic. This is because repair avoids the risks associated with prosthetic valves (increased likelihood of blood clots and consequent elevated risk of stroke) and the requirement for anti-coagulant medicine. If mitral valve repair is conducted in a timely manner, the short and long term prognosis are usually excellent.
Once the valve has been repaired (or replaced) the symptoms associated with mitral stenosis or regurgitation (e.g. shortness of breath and fatigue) should be resolved allowing the patient to enjoy a significant improvement in the quality of their life, however, this may not be the case if the heart had become severely damaged because of a heart attack or disease prior to treatment. A prosthetic mitral valve has a projected lifetime of between eight and fifteen years (after which it may need to be replaced).
- Stanford Medicine, Anatomy and Functions of the Heart Valves: https://med.stanford.edu/stanfordhospital/healthLib/greystone/heartCenter/heartIllustrations/anatomyandFunctionoftheHeartValves.html
- Mitral Valve Replacement and Repair, Mid-Atlantic Surgical Association: https://www.heartsurgeons.com/pr3.html
- Mitral Valve Repair, Cleveland Clinic: https://my.clevelandclinic.org/heart/disorders/valve/mvrepair.aspx
- Patient UK, Mitral Valve Operations: https://www.patient.co.uk/doctor/Mitral-Valve-Operations.htm