Preventing Heart Failure

The mitral valve is a blood flow regulator located between the left auricle and the left ventricle. When the left auricle contracts, the mitral valve opens to allow the flow of blood to the left ventricle. The auricle then relaxes to allow for contraction of the ventricle in order to supply blood in the body. However, insufficiency or regurgitation of the mitral valve may allow blood from the left ventricle to flow back to the auricle and eventually to the lungs. The condition leads to congestion of the lungs with blood and may also lead to a heart failure.

Causes of Mitral Regurgitation

The main cause of mitral insufficiency is congenital malformation but the condition can also be a result of infection, traumatic damage or heart failure. The fatality of mitral regurgitation depends on the severity of the backflow. Regurgitation is commonly characterized by swelling or oedema of the extremities, decreased exercise endurance and shortness of breath.

Treatment of Mitral Regurgitation

Medications can be used to reduce the severity of the condition but the most decisive treatment involves surgical valve repair or replacement. Replacement is usually done with a prosthetic valve.

Mitral valve repair is preferable to the replacement option because it offers several advantages to the patient.

Thus a mitral valve repair;

Gets rid of the need to use anticoagulants or blood thinners.
Reduces the risk of infections and stroke (endocarditis).
Preserves the normal functioning of the heart.
Increases the patient’s chances of survival.

Mitral valve replacement is only done when a repair cannot be successfully performed. It involves replacing the native valve with an artificial version made of animal or synthetic components.

Valve Repair Techniques

Cardiologists have devised several mitral valve repair procedures and choosing a method depends on the defect that caused the valve leakage.

Mitral Valve Prolapse Repair

Valve prolapse is a condition where the leaflets of the valve detach too much following each auricular contraction and the subsequent ventricular contraction occurs when they are still significantly apart. Blood thus leaks through the space between the leaflets and flows back to the lungs.

This condition is usually repaired by re-establishing a proper closing mechanism of the leaflets. This is done by:

Surgical removal of extra leaflet tissue.
Fixating the prolapsing leaflets back together.
Adjusting or replacing valve suspension mechanism.
Placing an artificial support around the valve.

Patching

Sometimes, mitral regurgitation occurs as a result of perforations in the valve leaflets. Repairing perforations involves covering them up with tissue patches removed from other parts of the body.

Minimally Invasive Surgical Approaches

Conventional this valve repair involves cutting through the breastbone so that the cardiologist may gain a straight access to the heart. This approach usually provides excellent results but the resulting wound may take several months to completely heal. The patient must also be kept away from activity during the recovery period and is normally subject to fatal complications including bacterial infection of the wound and even
death.

One of the most commonly used minimally invasive approaches is called “mini-thoracotomy”, where the surgeon gains access of the heart from between the ribs of the right side of the chest without actually splitting the sternum. Recovery from a minimum invasive surgery takes a shorter time and causes fewer traumas to the patient. Since only a small incision is done on the chest, chances of infection by bacteria are reduced quite significantly.