Mitral valve repair prognosis?

My situation wasn't exactly like yours, but I can perhaps provide a little insight. Six years ago at age 60 I had OHS to replace my mitral valve. Unlike you, my situation was acute and surgery was a must, not an option. The surgery wasn't a walk in the park, but after a couple of rough weeks I started feeling much better, with each day literally being noticeably better than the one before. In retrospect, even if my situation wasn't an emergency I would have had it done. My bovine valve is still working great - I assume I'll need a replacement in a half dozen years or so.

The financial piece I cannot comment on. At the time I had regular insurance so it wasn't that expensive. One piece of advice I will offer is if you have it done, try to do it at a high volume, well regarded facility. I had mine done in Central Florida at a local hospital (no opportunity to shop around in my case), and while the valve is well seated and working properly, I have had some arrythmia issues since the procedure. Maybe it would be a side effect no matter where I had it done, but I have to wonder if I had been able to go up to Mayo Jacksonville for example if that would be the case. At any rate, I feel fortunate to have my new valve. Best of luck with your decision.

@jefftalley Many thanks. To clarify, my valve condition is now very severe, and time is of the essence, according to the structural cardiologist I saw. They are talkingbrepair instead if replace.

I cannot go to Mayo or similar, but the regional hospital has a very good reputation.

Most of the feedback I've got is that you feel like the surgery was a big mistake for the first three months, you get prescribed an ever-changing array of drugs that make you feel weird, then you need a pacemaker and get a-fib, then you get used to the "new normal" and trudge on.

It is nice to hear you actually felt better!

I am 78 and got a mitral valve repair at Cleveland Clinic at age 59. I had been “followed” by my cardiologist for 15 years, waiting watchfully during that time for a reduced ejection fraction, enlargement of the heart, and most importantly, how I felt. When I reported that I was getting fatigued and somewhat breathless with walking uphill, the date for surgery was set. Not getting the repair would have meant definite heart failure in my future. My regurgitation was classified as “moderate” at the time.
I had only a few inches of my sternum cut to provide access to the mitral valve. The recovery was quick. I was swinging a golf club within 6 weeks, little chip shots within 3 weeks. First days you will be quite sore but extra strength over the counter pain meds were adequate. Today, minimally invasive ( small incisions/ no sternum cut) is often possible. Everybody is at risk for AFib after this surgery. They will give you meds beforehand to avoid that reaction. I got one dose of Amiodorone and it did the trick. Even if your heart does react to the surgery with AFib, it is typically very short-lived.
My Blue Cross/Blue Shield insurance covered it. I live in PA with access to good hospitals but wanted the best available. Cleveland was # 1 in the world at the time. I called the 800 number for the hospital, was transferred through to cardiac surgery, asked if the Chief of Cardio thoracic surgery was available. ( Bruce Lytle at the time, since retired) Answer was yes. That hospital is a well- oiled machine. They are incredibly organized from start to finish. Yes, you will be a number- but in a good way. Plus, they somehow keep costs down, and serve as a model for other hospitals trying to do the same.
I would recommend calling the hospital ( go online and check Cleveland’s website related to heart surgery) and asking about costs when insurance doesn’t cover everything. Many hospitals have options and help for you in this regard.
I flew back to Philadelphia 5 days after the surgery, having followed a brochure you are given documenting everything that will happen during those 5 days, assuming everything goes as expected. That little addition was wonderful if you’re the type who wants to be informed, without surprises. Following surgery recovery, I did not transform into a decathlon level athlete but did feel far more energized and was glad to have it behind me. 18 years later, my mitral valve repair is still hanging in with only “trace” leakage.
Go for it! You’re too young and too needed to reject the help available to you at this amazing time of medical expertise.