Keyhole Mitral Valve Repair

What is a Keyhole Mitral Valve Repair Surgery? 

What Is the Mitral Valve?

The mitral valve sits between the left upper chamber of the heart (the left atrium) and the main pumping chamber (the left ventricle). It opens and closes with each heartbeat to help blood flow in the correct direction.

When the valve does not close properly, blood can leak backwards. This is called mitral valve regurgitation. Mitral valve repair aims to improve how the valve closes while preserving the patient’s own valve where possible.

The exact repair technique depends on the valve anatomy and the cause of the leak. A surgical team may use one or more techniques to restore the valve’s function, such as supporting the valve with a ring, repairing the valve leaflets or addressing the supporting chords. The details of any proposed repair will be explained as part of your individual treatment

When Mitral Valve Surgery Is Needed

We usually recommend mitral valve repair surgery when:

• The mitral valve leak (mitral regurgitation) is severe, even if you don’t notice many symptoms
• The left atrium starts to enlarge, or you develop atrial fibrillation or pulmonary hypertension
• The valve is highly repairable, with a good chance of long-term success (over 95%) when the valve anatomy is suitable and surgery is performed in experienced centres.

Having surgery early can help prevent complications and maintain long-term heart health.  Your surgeon will consider your medical history and overall heart health when recommending surgery.

Benefits of Keyhole Mitral Valve Repair

Mitral valve repair offers several important benefits:

• A repair preserves heart function better than valve replacement
• Provides excellent long-term durability
• Often suitable for minimally invasive keyhole surgical techniques, which can reduce blood loss and recovery time
• Helps prevent the progression of valvular heart disease, atrial fibrillation and pulmonary hypertension

When mitral valve repair is performed using the minimally invasive keyhole method, many patients experience a smoother recovery compared with traditional open-heart surgery.

Patients undergoing keyhole surgery often experience:

• Less pain and discomfort after surgery
• Shorter hospital stay  
• Lower risk of wound infection
• Faster healing, measured in days rather than months
• Smaller scars
• Quicker overall recovery

Possible Complications of Keyhole Mitral Valve Repair Surgery

Minimally invasive mitral valve repair is generally safe for most patients when performed by experienced heart surgeons. Large clinical studies show that keyhole surgery has high quality outcomes similar to those of traditional open heart surgery at one year. One sepcific risk of minimally invasive mitral valve repair is conversion to traditional sternotomy which is very low at 1-2%. This means that in 98-99% of patients deemed suitable for minimally invasive mitral valve repair, no breastbone surgery is required.

The UK Mini Mitral trial found that serious complications such as repeat surgery, heart failure hospitalisation, or death occurred in only a small percentage of patients by one year after surgery.

Talk with your surgeon about your individual health, as personal factors like age and other medical conditions can influence risk and recovery. Regular follow‑up and monitoring help catch complications early and support the best long‑term results.

Your Assessment and Treatment Pathway

1. Initial enquiry and medical information. Contact the clinic and provide referral letters, clinic letters, scan reports or images where available. The team will explain how to share information securely.
2. Consultant assessment. Mr Inderpaul Birdi reviews your diagnosis, symptoms, medical history, imaging and treatment goals. This may take place in person or online where clinically appropriate.
3. Further tests or specialist input. Additional imaging or multidisciplinary discussion may be needed before a recommendation can be made.
4. Shared treatment decision. You will have the opportunity to discuss the potential benefits, risks, alternatives and practical implications of any proposed treatment.
5. Preparation, surgery and follow-up. If surgery is agreed, the team will explain pre-operative assessment, hospital arrangements, expected recovery milestones and follow-up care.

For information about rapid private assessment and possible treatment timelines, see heart surgery within two weeks of assessment. Any timeframe is subject to clinical suitability, required investigations, pre-operative preparation and availability.

How a Keyhole Mitral Valve Repair is Performed

If you have a leaking mitral valve, repair is often the preferred treatment. In many cases, this can be carried out using keyhole (minimally invasive) surgery.

Keyhole mitral valve repair is a minimally invasive procedure that carries fewer risks than traditional open-heart surgery. It is performed through a small incision on the right side of the chest, between the ribs, and does not require cutting any bone.

During a mitral valve repair, we may use one or more of the following techniques:

How We Test the Repair During Surgery

After the repair is completed, a simple but critical test is performed to confirm quality and effectiveness.

FAQs on Surgical Repair of Mitral Valves

Read the questions we hear most frequently at The Keyhole Heart Clinic about mitral valve repair surgery.

Contact us with any concerns or questions about mitral valve surgery. Our care team includes a mitral valve repair surgeon who provides hands-on guidance and support during your treatment.

Keyhole Heart Clinic: Keyhole Mitral Valve Repair Surgery

The next generation of heart surgery is available at The Keyhole Heart Clinic. Our clinic is led by Mr Inderpaul Birdi, a Cardiothoracic Surgeon and Consultant with over twenty years of experience helping patients through complex heart procedures.

Mr Birdi specialises in keyhole cardiac procedures, which use smaller incisions than those used in traditional open-heart surgery. These include:

• Keyhole coronary bypass surgery
• Keyhole mitral valve repair or replacement surgery
• Keyhole tricuspid valve replacement
• Keyhole aortic valve replacement
• Keyhole atrial fibrillation ablation
• Keyhole atrial septal defect closure

We also offer comprehensive heart screening services.

Ensure you have an effective treatment plan for mitral valve disease. Request a second opinion on mitral valve repair from the UK’s renowned heart specialist, Mr Birdi.

References

1. Akowuah EF, Maier RH, Hancock HC, et al. Minithoracotomy vs Conventional Sternotomy for Mitral Valve Repair: A Randomized Clinical Trial. JAMA. 2023;329(22):1957–1966. doi:10.1001/jama.2023.7800
2. Yandrapalli S, Sharma S, Kaplan J. Minimally Invasive Mitral Valve Surgery. [Updated 2024 Jul 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.