Is open heart surgery the best way to repair the Mitral Valve

Posted by jaybird24 @jaybird24, Mar 18 7:20pm

Is open heart surgery the best way to repair a leaking Mitral valve? Or will non-invasive surgery work as well?

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@tsc

I had open heart surgery to repair a leaky mitral valve with severe regurgitation in 2019. I was in the hospital for two weeks following surgery. It was challenging, but not as bad or nearly as painful as knee surgery I had when I was much younger.
I have read that because of the positioning of the mitral valve, the open heart technique is better/preferable.
I didn't have any help at home. Friends took me grocery shopping or picked up stuff and I was still caregiver to my husband with Alzheimer's Disease while I recovered.
I'm glad I had the surgery before I went into Congestive Heart Failure as my mom died from that. She had mitral valve stenois, but it was inoperable.

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You are a strong, and strong-willed person, Teri, and you have empathy and compassion as evinced by your care of your husband, even while recovering from major surgery. Good for you, and I hope you feel good about your actions and about your orientation to others forever.

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Hi @gloaming, you are kind!
I was being pragmatic when I decided to have the mitral valve repair. The cardiologist told me there were better outcomes when patients had the surgery sooner vs. later. My husband at that time was functional enough to manage staying in a hotel and taking a taxi to the hospital everyday when I was there. I thought if I put it off a few years we would crash and burn at the same time.
I'm glad I had the surgery when I did because since then I've developed other conditions that would certainly complicate things.
Take care.

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@gloaming

jaybird, do I have it correctly that you had a coronary bypass due to blocked artery, or were you on bypass for lungs and blood during open-heart surgery? I'm not clear on that. We're talking about being put on a heart and lung machine while they stop your heart so that they can do their work. When you're all set, sewn up, they paddle you and take you off of the machine, I believe over a minute or three...not sure. So, while they have your heart opened up, and your chest, you are on a 'bypass' machine.

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What do you mean they paddle you?
I just had my mitral valve repaired, and I swear I remember jumping about 5 times at one point and heard voices saying - good job, you're fine, etc.
But when I asked the surgeon afterwards, he acted like he didn't know what I was talking about.

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@pamschlegel

What do you mean they paddle you?
I just had my mitral valve repaired, and I swear I remember jumping about 5 times at one point and heard voices saying - good job, you're fine, etc.
But when I asked the surgeon afterwards, he acted like he didn't know what I was talking about.

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Often after a procedure they do a cardioversion to establish a 'corrected' rhythm. This involves placing electrode pads on your chest and rear and administering voltage to get your heart into a proper sinus rhythm. I used the term 'paddling' because it's what people have in mind when they jolt a heart back into rhythm or attempt to restart it...except a cardioversion doesn't normally involved 'paddling'...they use previously placed pads.

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Very good question.
You should look up The AHA/ACC guidelines for intervention in mitral stenosis.
Mitral stenosis due to calcific encroachment of the leaflets can progress to severe mitral stenosis at times(estimated to be 1 in 6 over 10 years).It does not lend itself to percutaneous valvuloplasty, and there are only case reports of using a percutaneous valve replacement option.
Patients with mitral stenosis should be monitored with yearly examinations, and echocardiograms should be performed more frequently as the severity of the obstruction increases.
All patients should initially be seen by a cardiologist, who can then decide how often the patient needs cardiology follow up and whether intervention is indicated.
for mitral valve regurgitation the use of Mitraclip in patients with secondary mitral regurgitation and high surgical risk.
All patients with more than mild mitral regurgitation should be referred to a cardiologist for an evaluation.
Serial examinations and echocardiograms and surgical referral made if certain criteria are made.
There is evidence that mitral valve repair should be done early in the course of the disease to improve mortality and morbidity.

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