Mitral Valve Repair
Mitral Valve Repair is the best option for nearly all patients with a leaking (regurgitant) mitral valve and for many with a narrowed (stenotic) mitral valve. Compared to valve replacement, mitral valve repair provides better long-term survival, better preservation of heart function, lower risk of complications, and usually eliminates the need for long-term use of blood thinners (anticoagulants).
Aortic Stenosis & Valve Replacement Surgery
Valve replacement surgery is the only treatment for aortic stenosis. Because patients with aortic stenosis often also have blockages in the coronary arteries, or coronary artery disease (CAD), surgeons typically treat significant blockages by performing bypass surgery at the same time. For this reason, most patients undergo cardiac catheterization before valve replacement surgery to detect blockages in the coronary arteries.
Replacement of the aortic valve requires open-heart surgery, in which the breast bone (sternum) is split down the middle, allowing access to the heart. The heart is stopped during critical parts of the operation and a special machine pumps oxygenated blood throughout the body. The diseased valve is removed and a new valve is sewn in.
There are three basic types of valves used to replace the diseased heart valve. A porcine valve is made of tissue from a pig. The advantage of a porcine valve is that it poses no significant risk for blood clots on the valve; thus, patients do not require blood thinner medication. The disadvantage is that after approximately 10 years, these valves may degenerate and must be replaced.
A mechanical valve is fashioned from metal and synthetic materials. The most commonly used mechanical valve, St. Jude’s valve consists of two semicircular discs that open with each contraction of the left ventricle and close when the ventricle relaxes. The advantage of a mechanical valve is that it is quite durable, often lasting more than 20 years. The disadvantage is that there is a small risk for a blood clot to form on the valve. This blood clot can break off, travel to the brain, and cause stroke. To prevent this complication, patients who receive mechanical heart valves are treated with warfarin (Coumadin), a blood thinner that decreases the risk for blood clot formation.