Mitral Valve Surgery Options: Repair vs. Replacement

Mitral valve surgery is a critical treatment option for patients suffering from mitral valve disease. The two primary surgical approaches are mitral valve repair and mitral valve replacement, each with its own benefits and considerations.

Mitral Valve Repair

Mitral valve repair involves restoring the structure and function of the damaged mitral valve. This procedure is often preferred when possible, as it preserves the natural anatomy of the heart and supports long-term cardiac function. Repair techniques may include removing excess valve tissue, reconnecting valve leaflets, or reinforcing the valve with an annuloplasty ring.

One of the major advantages of repair over replacement is the avoidance of lifelong anticoagulation therapy, which is necessary with mechanical valves. Additionally, successful repair eliminates the need for future valve replacement, reduces the risk of endocarditis, and allows for quicker postoperative recovery.

Mitral Valve Replacement

Mitral valve replacement is typically recommended when the valve is too damaged to be repaired effectively. In this procedure, the damaged valve is replaced with either a mechanical or a biological prosthetic valve.

Mechanical Valves

Mechanical valves are known for their durability and can last a patient's lifetime. However, they require lifelong anticoagulation therapy to prevent blood clots. Inadequate anticoagulation can lead to serious complications such as embolism or valve dysfunction, while excessive anticoagulation increases the risk of bleeding.

Biological Valves

Biological valves, often made from animal tissue, do not require long-term anticoagulation, making them a safer option for certain patients. However, their lifespan is limited to approximately 10 to 15 years, after which another surgery may be necessary to replace the valve.

Impact on Longevity and Quality of Life

Both mitral valve repair and replacement can significantly affect a patient's life expectancy and quality of life. Successful valve repair often allows patients to live without major restrictions, while valve replacement, especially with a mechanical option, involves ongoing management and lifestyle adjustments.

Compared to replacement, repair offers additional benefits such as preserving left ventricular function, reducing the risk of heart failure, and improving overall cardiac performance. For these reasons, whenever feasible, mitral valve repair is considered the gold standard in treating mitral valve disease.