Mitral valve surgery
Unlike the aortic valve, many patients with mitral valve disease who require surgery will benefit most from mitral valve repair rather than replacement.
Mitral valve repair
Repairing a mitral valve confers many advantages including preserved heart function, reduced surgical mortality, and avoidance of anticoagulation. The procedure requires considerable experience.
As one of the best mitral valve surgeons, Mr Inderpaul Birdi can also perform this complex procedure through keyhole incisions in many patients with excellent results.
The probability of repair depends upon a number of factors:
- Posterior leaflet prolapse 95% to 98% chance of perfect repair
- Anterior leaflet prolapse 85% to 90% chance of perfect repair
- Bileaflet prolapse 70% to 80% chance of perfect repair
The presence of extensive leaflet calcification limits the quality of repair and is therefore only performed in highly selected cases.
If the valve cannot be repaired, then mitral valve replacement will be required.
Mechanical valve replacement
The benefit of mechanical valve replacement lies in the fact that modern valves demonstrate little or no evidence of structural deterioration. Their only caveat is that they can promote clot formation on their surface. For this reason, patients require life long anticoagulation with Warfarin, a daily tablet, which inhibits the clotting mechanism. A patient on Warfarin requires regular blood tests in order to ensure that the degree of inhibition is optimal. Excessive anticoagulation can produce dangerous bleeding complications that are more common in older patients.
Bioprosthetic (Tissue) valve replacement
A bioprosthetic valve can be made from pigs’ valves or from the pericardium of a cow. There is no risk of cross infection and Warfarin is not a requirement. Unfortunately, bioprostheses can wear away. Patients over the age of 70 years old can expect a durability of 75 to 80% at 10 years postoperatively. Younger, more active patients will wear down these valves much quicker.
Both mitral valve repair keyhole surgery and mitral valve replacement keyhole surgery is offered via The Keyhole Heart Clinic.