Your heart can develop problems with one of the four valves that regulate blood flow in and out of the atria and ventricles (upper and lower chambers, respectively). These problems can be minor or severe. In the latter case, if left untreated, valvular disorders can cause a number of symptoms that can dramatically impact your quality of life.

One of your heart's four valves is called the mitral valve (MV). It is located between the left atrium and left ventricle. This valve is partly responsible for allowing oxygen-rich blood to flow to the rest of your body. This article will provide an overview of mitral valve repair surgery. We'll describe the disorders that affect the MV and explain the procedures surgeons can perform to address them. You'll also learn what to expect once your MV has been repaired.

Problems Corrected Through Mitral Valve Repair

Your mitral valve has two leaflets (i.e. flaps) and can suffer two main disorders: regurgitation and stenosis. Regurgitation occurs when one of the leaflets fails to close properly after the left atrium has emptied of blood. When the left ventricle contracts to push blood out of your heart, some of the blood flows back through the partly-open valve into the atrium. This is known as a regurgitant flow.

Stenosis, on the other hand, occurs when the leaflets stiffen. They fail to open properly when the atrium contracts in order to push blood into the ventricle. A portion of the blood flows through the restricted opening while some remains inside the upper chamber.

In both cases, your heart becomes less efficient in circulating blood. Instead, blood pools inside the atrium, increasing the risk of clots. If either condition is mild, your doctor may simply prescribe anticoagulants to reduce the likelihood of clotting. If the disorder is severe, he or she may suggest mitral valve surgery.

The Procedure Explained

The surgical procedure used depends on the type of disorder and the leaflets that are affected. Stenotic MVs (i.e. those that are narrowed) can usually be resolved with an approach called balloon valvuloplasty. A cardiologist will insert a catheter in your groin and guide it to your heart. A small hole is created in the upper septum in order to pass the catheter from the right to the left side. The catheter is then guided to the stenotic mitral valve. A small balloon on its end is inflated, widening the gap between the stiffened leaflets.

Regurgitant MVs require a completely different approach. If the posterior leaflet is failing to close completely, your surgeon can perform a triangular resection. An annuloplasty ring is often used to support the newly-repaired MV. If the anterior leaflet is failing the close, a chordal transfer is performed. Chordae from the posterior flap is used to support the anterior flap.

After The Procedure Has Been Performed

In the past, mitral valve repair was done exclusively through open heart surgery. With this approach, a long incision is made into the chest and the sternum is cracked to provide the surgeon access. The patient's heart is stopped and a heart-lung machine is used to circulate blood while the surgeon performs the repairs. This approach is still used today for many patients.

A better approach is minimally invasive mitral valve repair. The surgeon can complete the repairs without needing to arrest the heart. As a result, the recovery period is far shorter than would be the case following open heart surgery. Moreover, there is less risk of infection and bleeding, a lower likelihood of complications, and less pain during recovery.

If you suffer from a stenotic or regurgitant MV, and have experienced severe symptoms (e.g. shortness of breath, fatigue, etc.), ask your physician about minimally invasive mitral valve repair. It may represent the best solution for your circumstances.