Specifically, mitral valve disease indicates either mitral stenosis or mitral regurgitation. Mitral stenosis has been linked to rheumatic fever or any complication causing inflammation of the heart, such as streptococci infection, states Leonard S. Lilly, M.D., author of "Pathophysiology of Heart Disease." In mitral stenosis, the heart's mitral valve becomes narrowed due to build up of calcium deposits. Mitral regurgitation happens when the valve doesn't close properly, allowing blood to flow backwards into the heart. Both mitral valve diseases reduce the amount of blood flowing to the heart and body, resulting in shortness of breath and fatigue, and more serious complications such as heart failure. There are three types of surgical procedures commonly used in the treatment of mitral valve disease.
Mitral Valvuloplasty
First introduced in 1985, balloon mitral valvuloplasty is a minimally-invasive surgical procedure used in treating mitral valve stenosis, says physician-author Lilly. During this surgery, a balloon-tipped catheter is sent from the leg's femoral vein all the way up into the diseased mitral valve. The balloon is then inflated, effectively breaking the calcium deposits and improving the valve's function. According to Lilly, the results of this procedure compare favorably to those of more invasive procedures with patients suffering from mild mitral stenosis.
Mitral Valve Reconstruction
Mitral valve reconstruction, also referred to as open mitral commissurotomy, is a more invasive, open-heart surgical procedure for treating mitral stenosis and regurgitation. With the heart fully exposed, the physician removes the calcium deposits and any blood clots that formed in the left atrium as a result of mitral stenosis. In the case of mitral regurgitation, the tendons responsible for closing the mitral valve, which have been damaged, can be reattached and repaired. For mitral stenosis patients considering mitral valve reconstruction, this procedure is much more involved and costly compared to balloon mitral valvuloplasty, says Michael H. Crawford, author of "Current Diagnosis and Treatment in Cardiology."
Mitral Valve Replacement
Mitral valve replacement is reserved for patients with severe cases of mitral stenosis, or suffering from mitral regurgitation, says Crawford, chief of clinical cardiology at University of California, San Francisco Medical Center. A mechanical, human donor or animal valve are available options for replacing the diseased valve. The type of replacement valve chosen depends on a multitude of factors such as the patient's preference, age, lifestyle and existence of any other complications. Mechanical valves offer more durability than those of human or animal origin; however, mechanical valves require life-long medication to prevent blood clot formation in the heart. Mitral valve replacement is associated with lower rates of survival compared to valve reconstruction, explains Robert R. Moss M.D., author of "Outcome of Mitral Valve Repair or Replacement" published in the medical journal "Circulation."
References
- "Pathophysiology of Heart Disease"; Valvular Heart Disease; Leonard S. Lilly, M.D.; 2007
- "Current Diagnosis and Treatment in Cardiology"; Mitral Stenosis; Michael H. Crawford; 2009
- "Outcome of Mitral Valve Repair or Replacement"; Circulation; Robert R. Moss, M.D.; 2003
