Mitral valve replacement

Among the most common surgical interventions involving this organ is the replacement of the mitral valve, located between the left atrium and the left ventricle. The mitral valve prevents the backflow of blood into the atrium (regurgitation), which can lead to its stretching, deformation, and the development of arrhythmias, heart failure, and other pathologies. In cases of pronounced defects in the mitral valve that cannot be repaired through therapeutic treatment or valveoplasty, a replacement is necessary.

When is mitral valve replacement surgery needed?

The mitral valve of the heart is directly involved in the process of pumping blood, constantly subjected to significant blood flow pressure. Among the other parts of the heart, it is most susceptible to pathologies and defects. Functional disorders of this valve manifest as incomplete closure of the valve opening. This disrupts normal blood circulation, forcing the heart to work under increased load. The causes of such dysfunction remain not fully studied. They may include:

• connective tissue pathology, for example, dysplasia, manifested by increased tissue flexibility;
• past infectious diseases resulting in inflammation of the heart's inner lining covering its valves. Connective tissue develops on the leaflets of the mitral valve, leading to scarring and adhesion formation, which results in leaflet prolapse and incomplete closure of the atrial entrance;
• pathologies of the myocardium and heart muscles that attach the valve;
• deposits of mineral salts on the leaflet walls;
• rheumatism and other causes.

At early stages, mitral insufficiency is treated with therapeutic methods combined with a diet and moderate physical activity. In more complicated cases, mitral valve plastic surgery may be required – a surgical procedure for reconstructing the valve that has pathological changes.

Replacement of the mitral valve is necessary in the presence of the following indications:

• the impossibility of effective surgery to dissect adhesions between the valve leaflets (commissurotomy);
• the presence of pronounced fibrosis (thick layers of connective tissue) on the valve leaflets;
• significant calcification on the leaflets (calcium deposits);
• the occurrence of leaflet retraction and tendinous chord changes.

Features of mitral valve replacement surgery

Mitral valve prostheses can be mechanical, made of silicone, metal, and other materials, or biological, for which tissues from the hearts of cattle, horses, or pigs are used. The lifespan of a mechanical valve is unlimited, but lifelong anticoagulant therapy is required upon its installation to prevent thrombus formation. A biological prosthesis, over time (usually after 10-15 years), requires replacement, as it is susceptible to calcification and wear.

Surgery on the mitral valve for the purpose of plastic surgery or replacement with a prosthesis is currently performed through annuloplasty (open-heart surgery) or minimally invasive methods. In the first case, the valve replacement surgery lasts about 6 hours. It is conducted under general anesthesia, including the following stages:

• suturing the surgical wounds;
• gradually disconnecting the operated patient from the artificial circulation system.

The minimally invasive method involves valve replacement without sternotomy and connection to the artificial circulation system – through a small incision with the introduction of an implant alongside a fiber optic probe into the heart cavity. In this case, the process of the surgery is controlled on a display.

At the Dobrobut Clinic’s cardiac surgery center in Kyiv, minimally invasive techniques for performing surgery on the plastic or replacement of the mitral valve are actively implemented. The cost of minimally invasive surgery or annuloplasty is significantly lower than similar services in clinics in the USA, Europe, and even Israel. The use of advanced techniques, the most modern medical equipment, and the participation of experienced specialists (cardiologists and cardiac surgeons) are the main advantages of our clinic. Schedule an appointment with a cardiologist directly on our website!