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Minimally Invasive Mitral Valve Repair/Replacement (MVR) Procedure

The minimally invasive mitral valve repair procedure is a minimally invasive direct vision approach to treat the narrowing or leaking of the heart's mitral valve. The mitral valve is the inflow valve on the left side of the heart, which allows blood to flow from the left atrium into the heart's main pumping chamber. A correctly functioning mitral valve then closes to keep blood from regurgitating back into the left atrium of lungs when the heart contracts to pump blood through the body. The procedure is performed under direct vision by creating a 5-6 cm incision between the 4th or 5th ribs and using a wound retractor to improve visibility. This approach means patients experience a shorter hospital stay, which lowers the overall cost of care and allows a return to full activity in three to four weeks compared to three to four months for standard surgery.

What is Heart Valve Repair?

During a heart valve repair operation, your heart valve may need to be resized (an annuloplasty procedure). In addition, extra valve tissue may need to be removed, holes in the leaflet repaired, or support structures called chords replaced.  Valve repair may include all of the following procedures:

  • The heart valve is resized by removing excess tissue
  • Support is added to the heart valve by adding tissue or a band or ring around the opening of the valve
  • Damaged leaflet tissue is repaired
  • Calcium deposits are removed
  • The cords that control the leaflets of your valve are repaired or replaced

Valves are essential to your heart's pumping action. The four valves direct blood to move between your heart's four chambers.

If you and your surgeon agree that heart valve repair is the best option for you, he may perform an operation called an annuloplasty procedure.

Through disease or age, the tissue that supports the heart valve's leaflets (the annulus) can weaken and lose its shape. To repair this condition, a device called an annuloplasty ring or band is sewn around the base of the heart valve to reshape it and give it support.

An annuloplasty band or ring is made of durable plastic, metal, or fabric and may be flexible or rigid. These rings and bands are designed to hold the natural shape, motion, and flexibility of the annulus.

Courtesy: Medtronic

An annuloplasty ring or band may also have a marker that makes it possible to see it on an x-ray.

A flexible annuloplasty ring or band is used to help restore the shape of your heart valve.

Many patients feel physically better following heart valve repair surgery because they are no longer impacted by the symptoms of their valve disease.

Often a leaking mitral valve is associated with a broken chord.  These chords hold the leaflet in the proper position.  This can be repaired by replacing the broken chord with a Teflon suture.  This procedure is called Artificial Chord Replacement (ACR).

Benefits and Risks - Heart Valve Repair

Depending on your condition, you should begin to feel the effects of your heart valve repair soon after surgery.

Benefits

Most patients feel the results of valve repair surgery immediately. Others notice a gradual improvement over several weeks following their surgery. Your doctor will help you evaluate your progress and recommend programs and activities to help restore your strength and energy.

Risks

There are obviously risks associated with heart surgery.  They can vary from patient to patient.  Talk with your surgeon to learn more about the benefits and risks of heart valve repair surgery.

Questions and Answers - Heart Valve Repair

Is it safe to have an x-ray after heart valve repair?

All heart valve repair products are safe with x-ray examinations.

Is it safe to have a magnetic resonance imaging scan after heart valve repair?

Typically yes.  Ask your surgeon for more details.

Is it safe to go through airport security after heart valve repair?

Airport security systems have no effect on our heart valve repair products. They are unlikely to set off airport security alarms, depending on the sensitivity of the security settings.

What about cell phones, electric toothbrushes, and magnets?

None of these items will cause problems with your heart valve repair product.

What is Heart Valve Replacement?

During a heart valve replacement procedure, the surgeon removes your diseased heart valve and replaces it with what's called a prosthetic or artificial heart valve. This artificial valve works much like a normal heart valve.

An artificial heart valve is either a mechanical or a tissue valve. Mechanical heart valves are made of a strong material such as titanium or carbon. Tissue heart valves are obtained either from human donors or from animal tissue.

After receiving your new heart valve, you will likely begin noticing an immediate improvement in how you feel. Complete recovery may take approximately 6 to 12 weeks. Most heart valve patients resume a normal, healthy lifestyle.

Benefits and Risks - Heart Valve Replacement

 

eart valve replacement surgery is generally considered safe, and you should feel some benefits of your new heart valve almost immediately. However, risks and complications are possible. You need to know about them so you can alert your doctor if you notice symptoms.

Benefits

Over time, you should be able to engage in your normal activities again. Each patient recovers at his or her own pace. Recovery depends on your overall strength. The effects of your old, damaged valve on your body will gradually fade as your new heart valve begins to help your heart function more efficiently.

Risks

There are obviously risks associated with heart surgery.  They can vary from patient to patient.  Talk with your surgeon to learn more about the benefits and risks of heart valve replacement surgery.

Questions and Answers - Heart Valve Replacement

Should I get a mechanical valve or a tissue valve?

There are advantages and disadvantages with either choice. Your doctor can provide more details. A mechanical valve lasts longer than a tissue valve, but you'll have to be on blood-thinning medication for the rest of your life to reduce the risk of clots. The main advantage of a tissue valve is that it does not typically require this.

You and your doctor together will decide which option is best for you.

How long will my heart valve last?

Mechanical valves in some patients have lasted as long as 25 years without problems.1 So, it is possible that your new artificial valve could last for the rest of your life. But in some cases, a valve has to be replaced within a matter of years or months, for a number of reasons.

Mechanical valves are more resistant to the constant demands on them, such as opening and closing each time your heart beats. The materials used in mechanical valves stand up well to this wear and tear.

Tissue valves don't tend to last as long as mechanical valves. They can tear and leak over time. Tissue valves usually have to be replaced after about 10 to 15 years,2 or more often in younger patients or children who may have outgrown their valves.

Fortunately, tissue valves wear out slowly so you and your doctor have time to plan for a new operation, if it is necessary.

Will my new valve need special care?

Let your other doctors and your dentist know that you've had heart valve surgery. Ask whether you should take antibiotics before surgical or dental procedures to help prevent valve infections.

Will a mechanical heart valve set off airport security?

No. Airport security systems have no effect on replacement valves. They are not likely to activate airport security alarms, depending on the sensitivity of the security settings. Learn More: Transportation Safety Administration Website.

Is it safe to have an x-ray after heart valve replacement?

All replacement heart valves are completely safe with x-ray examinations.

Is it safe to have a magnetic resonance imaging scan after heart valve replacement?

Our replacement heart valves have been tested and found to be safe during a magnetic resonance imaging (MRI) scan. Contact Medtronic LifeLine CardioVascular Technical Support for more detailed information.