Heart valve problems involve narrowing (stenosis) or leakage (insufficiency or regurgitation) of the aortic valve (primary outlet valve of the heart) or Mitral valve (primary valve between the upper and lower chambers of the heart). All blood pumped by the heart passes through these valves. Problems can be caused by rheumatic fever or simply by degenerative changes occurring over many years. Certain systemic illness and disease can contribute to the development of valve problems including auto immune disease such as arthritis, infections and kidney failure.
Causes
Mitral valve disease may be due to rheumatic disease but currently is caused most often by Mitral valve prolapse syndrome, a poorly understood phenomen in which the valve slowly becomes thickened, elongated and begins to regurgitate blood back into the upper chamber of the heart causing heart failure. The mitral valve resembles a parachute in that long chords hold it in place. These chords may rupture and result in sudden worsening of the valve leakage.
Mitral valve prolapse (MVP) occurs when one of your heart's valves doesn't work properly. MVP is one of the more common heart valve conditions. Most often, it's a lifelong condition that a person is born with. Most people with MVP have no symptoms or problems, need no treatment, and are able to lead normal, active lives.
MVP puts you at risk for infective endocarditis, a kind of heart infection. To prevent it, doctors used to prescribe antibiotics before dental work or certain surgeries. Now, only people at high risk of endocarditis need the antibiotics.If you need treatment for MVP, medicines can help relieve symptoms or prevent complications.
Symptoms
Most people with Mitral valve prolapse have no symptoms, however, those who do commonly complain of symptoms such as fatigue, palpitations, chest pain, anxiety, and migraine headaches. Stroke is a very rare complication of Mitral valve prolapse.
Fatigue is the most common complaint, although the reason for fatigue is not understood. Patients with Mitral valve prolapse may have imbalances in their autonomic nervous system, which regulates heart rate and breathing. Such imbalances may cause inadequate blood oxygen delivery to the working muscles during exercise, thereby causing fatigue.
The surgeon will then make an incision known as a median sternotomy, and the patient is then placed on cardiopulmonary bypass. While on bypass, blood that returns to the heart is removed and pumped through the "heart-lung machine," which oxygenates the blood. The blood is returned to the aorta, thus bypassing the heart and providing oxygenated blood to the body during surgery. The body temperature of patient is lowered using imitralce packs for the duration of the surgery.
There are a variety of surgical techniques that are used to repair the Mitral valve. The surgeon will carefully review images from echocardiography and visually assess the valve and surrounding structures before deciding on the technique of repair. There are two main areas that the surgeon focuses on during the repair. The first is to fix any abnormal motion of the valve leaflets and repair chords. The second is to reinforce the annulus by implanting a ring. If the leaflets are enlarged, the surgeon may need to remove excess tissue from the valve leaflets and resuture the edges together. The surgeon may also need to repair damaged chords with sutures or place new artificial chords to keep the leaflets in place.
The primary method used to repair a Mitral valve is known as "annuloplasty." During annuloplasty, the surgeon will place an artificial ring around the annulus. This ring reinforces the annulus and restores the size and shape of the annulus. The function of the Mitral valve leaflets is often restored through this process.
In some cases the Mitral valve is so diseased that repair cannot be attempted and the valve must be replaced. The surgeon will often need to visually assess the valve before determining if a Mitral valve repair is possible.
This allows the patient to be treated postoperatively with simple blood thinners such as baby aspirin rather than the more powerful anticoagulant required after most valve replacements.
Repair can be performed in 90-95% of cases of Mitral leakage due to prolapse syndrome.
Hospital stay of would typically be for about 8 days.
The other major cardiac procedures are:
Few popular hospitals for Mitral Valve Repair are:
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