Mitral Valve Prolapse Repair

Mitral valve prolapse occurs when portion(s) of one or both of the mitral valve leaflets or the tissue filaments (”chordae”) that hold these leaflets in place become floppy and allow these leaflet segments to float backwards into the upper heart chamber (left atrium) instead of closing up against the opposing valve leaflet. If the condition is severe enough, blood may flow backward between the leaflet segments into the left atrium rather than all of it flowing completely in one direction (regurgitation). If left untreated, mitral valve prolapse can also lead to symptoms of shortness of breath and even congestive heart failure and premature death.

Surgical Procedure

During surgery to repair mitral valve prolapse, we are able to perform “plastic surgery” on your own heart valve so that we do not need to replace it with an artificial valve. As seen in the figure below, the surgeon is able to cut away the loose, prolapsed section of leaflet known as a “triangular” resection (A and B). The edges of the leaflet next to this cut away section are joined and sewn together (C). A special cloth and metal ring is then sutured around the repaired valve to compress the leaflets together, adding strength and stability to the repair (D).

Scott Holmes

Triangular, posterior mitral valve leaflet repair.

Symptoms of Valve Prolapse

Chest pain
Fatigue
Dizziness
Shortness of breath

Outlook

After surgery, you will recover in an intensive care unit usually overnight, and then for a few days in a monitored hospital room before you are discharged. In general, you will feel much better than you were feeling before surgery within days to weeks after surgery, but recovery from heart valve surgery can take several months until you feel fully recovered.

References

Rosengart TK, Feldman T, Borger MA, et al. Percutaneous and minimally invasive valve procedures: a scientific statement from the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2008 Apr 1;117(13):1750-67.

Dang NC, Aboodi MS, Sakaguchi T, Wasserman HS, Argenziano M, Cosgrove DM, Rosengart TK, Feldman T, Block PC, Oz MC. Surgical revision after percutaneous mitral valve repair with a clip: initial multicenter experience. Ann Thorac Surg. 2005 Dec;80(6):2338-42.