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Mitral Valve Repair

Mitral valve repair is heart surgery performed to repair a malfunctioning mitral valve, due to narrowing (stenosis) or leakage (regurgitation). The mitral valve can malfunction because of a congenital abnormality (abnormal from birth) or an acquired disease (diseased with age) or as a result of rheumatic fever. In rare instances the mitral valve can be destroyed by infection or a bacterial endocarditis. Mitral regurgitation may also occur as a result of ischemic heart disease (coronary artery disease).

Top view of the heart, showing the mitral valve, coronary sinus, left coronary artery, pulmonary artery with valve, aortic valve, right coronary artery, and tricuspid valve.

Repairing a Stenotic (Narrow) Mitral Valve

One type of mitral valve repair is called mitral commisurotomy, performed on valves that are stenotic, or narrow, either from birth or from damage by rheumatic fever. Most often today, rheumatic mitral stenosis is treated by balloon valvuloplasty, a procedure performed in the cardiac catheterization laboratory by interventional cardiologists. Using a catheter with a balloon on the end, the balloon is expanded inside the valve to "stretch" it open.

Repairing a Regurgitant (Leaking) Mitral Valve

More often, mitral valve repair is performed to correct a leaking, or regurgitant, valve. Congenital mitral regurgitation may be due to a cleft mitral valve (a valve with a separation or cleft down the middle) associated with an atrial septal defect, a type of hole in the heart between the low pressure chambers or atria. Such valves can sometimes be repaired simply by closing the cleft with sutures. Mitral valve disease also may be due to an elongation or rupture of the chordal apparatus, the "heart-strings" that support the valve normally, or due to a more generalized weakness of the valve itself, such as the "floppy valve" syndrome in which all of the components of the valve are enlarged and elongated.

Patients that undergo mitral valve surgery require prophylactic antibiotics as a preventive measure against infection whenever dental work is done.

 

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