Mitral valve repair surgery is performed in Turkey to treat most mitral valve diseases before the valvular problem progresses and causes systemic injury to the patient that ends in death.
An overview of the mitral valve
The mitral valve or what is known as the “mitral valve” is one of the four valves of the heart that keeps blood flowing in the right direction. It is a bicuspid valve consisting of two leaflets attached by tendons and papillary muscles that separate the two chambers of the heart, the left atrium and the left ventricle.
The posterior leaflet of the mitral valve is C-shaped and the anterior leaflet has the shape of a semi-circle corresponding to the posterior leaflet. The name of the valve comes from the fact that the two leaflets of the valve have the shape of a crown worn by bishops.
The mitral heart valve serves to prevent the return of blood from the left ventricle to the left atrium; In each heart cycle, the ventricle walls expand so that blood travels from the left atrium to the left ventricle through the mitral valve.
The mitral valve may be infected congenitally or with age, with damage or disease, and it does not work well and not enough blood reaches the left ventricle, which makes the heart unable to meet the needs of the body with blood rich in oxygen.
Most people with mitral valve disease do not have clear symptoms that indicate the disease, but if the condition is left untreated, the problem may become serious and lead to life-threatening complications such as heart failure andArrhythmia.
Types of mitral valve disease
Mitral valve problems are usually classified into three types:
- Mitral valve stenosis: The leaflets of the mitral valve become hard or calcified and the valve does not open sufficiently, and this leads to insufficient blood flow to the left ventricle
- Mitral valve insufficiency (mitral valve regurgitation): When the mitral valve closes, its leaflets do not fit together, which leads to leakage of a quantity of blood from the left ventricle to the left atrium during ventricle contraction.
- Mitral valve prolapse: Prolapse occurs when one or both leaflets of the mitral valve protrude into the left atrium during contraction of the ventricles, the valve does not close properly and blood leaks into the left atrium, so some consider it a form of mitral insufficiency.
How is mitral valve disease diagnosed?
It is important to perform routine cardiac examinations, especially in old age, in order to diagnose mitral valve diseases early and treat them as soon as possible before the condition develops and we have to change the mitral valve.
When the doctor suspects the presence of mitral valve disease, he will listen to the patient's heartbeat with a stethoscope, and then do additional tests and examinations that help him confirm the diagnosis of mitral valve disease.
Some of the methods that are used in the detection of mitral valve diseases:
- Echocardiography (echo): This technique uses ultrasound to visualize the mitral valve, and is considered the most important diagnostic tool in determining the cause and severity of valvular damage.
- Simple chest photo: It is done by simple rays, and its importance is focused on detecting cardiac hypertrophy or heart failure.
- Cardiac catheterization: This procedure allows to perform many tests such as angiography of the heart and give information on blood flow and heart health, as well as the possibility of using cardiac catheterization As a therapeutic tool in some cases.
- Electrocardiogram: It is used to see the electrical activity of the heart and use it to detect many complications resulting from problems with the mitral valve.
- Intensity test: An electrocardiogram is performed during exercise in order to assess the heart's response to physical stress.
Mitral valve repair in Turkey
When the mitral valve is not working well, the doctor may prescribe some medications to increase the contractility of the heart and thus increase the blood supply to the arteries of the body without treating the main problem.
Mitral valve problems are mechanical problems that can not only be treated with medication, but surgery must be performed to repair or replace the damaged mitral valve, and leaving the condition untreated may reduce the options available to the patient.
Why should the mitral valve be repaired rather than replaced?
Repairing the affected valve is better than replacing it, as the repair alone is able to restore the normal function of the heart, because this leads to avoiding the complications that can occur in the heart. Mitral valve replacement surgery It also leads to a longer survival rate without the need for prolonged use of blood-thinning drugs as in the replacement of the mitral valve with prosthetic valves.
It should be noted that most cases of mitral valve insufficiency (which is often caused by mitral valve prolapse) and some cases of mitral valve stenosis can be treated in Bimaristan Medical Center In Turkey, by “mitral valve repair surgery” due to the development in this regard and the new technologies that have been discovered.
In addition, more than half of all cases of mitral valve insufficiency can be repaired with Minimally Invasive Techniques Requires 2 to 4 small surgical incisions instead of a procedure open heart surgeryThis is based on pre-operative tests that determine the optimal procedure for each patient.
Advantages of Mitral Valve Repair
Mitral valve repair surgeries are superior to Mitral valve replacement surgeries Several features, including:
- Improving lifestyle in patients with mitral valve insufficiency
- Longer survival rate compared to mitral valve replacement
- Maintain better heart function
- The risk of stroke and infection is lower
- No need to take blood-thinning drugs
I have performed A study To compare the mortality rate from these two procedures on a large sample of mitral valve patients, the ratio was 3.9% for mitral valve repair and 8.9% for mitral valve replacement.
Mitral valve repair is also more challenging than mitral valve replacement surgery, and surgeons often tend to repair the valve rather than replace it for the best result.
How is mitral valve repair in Turkey?
Before surgery begins, the surgeon determines which leaflet will be repaired (anterior, posterior, or both), what technique is most appropriate for the repair and what surgical procedure he will use to access the mitral valve.
There are many techniques used to treat mitral valve stenosis or insufficiency, some of them require open-heart surgery and others can be performed using minimally invasive techniques through a robot or catheter as described inthe video.
In all mitral valve repair or restoration, the patient will be placed under general anesthesia and connected to a cardiopulmonary bypass machine (except for techniques that use catheters, which are done without a bypass device).
The operation usually takes 4-6 hours, but this varies according to the type of surgery and the technique used.
In this technique, the mitral valve annulus on which the mitral valve leaflets are supported is narrowed and strengthened by attaching a tissue, fabric or metal ring (or semi-ring) to it.
It should be noted that all mitral valve repair techniques may require angioplasty to maintain the original size of the mitral valve and re-sealing of the valve leaflets again so that the repair of the mitral valve lasts longer.
This technique involves cutting and removing the affected part of the valve leaf in a triangular shape, then attaching the edges of the cut to the surgical electrode. This technique is usually used when the posterior leaflet prolapse occurs.
Similar to the previous method in that the resection of the posterior leaflet is wider (from the free edge of the valve to the annulus of the mitral valve), this method is used in special cases of posterior leaflet prolapse.
The tendons perform the function of fixing the valve leaf to the inner walls of the heart and preventing it from drooping toward the atrium. Any stretching or interruption of these tendons leads to mitral valve prolapse and consequently its failure.
This technique involves replacing one or more elongated or severed tendons with prosthetic tendons made of a non-absorbable material such as Gore-Tex and is often used in anterior leaflet prolapse of the mitral valve.
Another way to repair anterior mitral valve prolapse is to move a normal tendon with a portion of the posterior leaf attached to it to the area containing the anomalous tendons of the anterior patella, and reconnect the cutting edges into the posterior leaf.
Both methods have excellent results in the long run.
This technique is often used in cases of septic endocarditis affecting the commissure of the mitral valve (the junction of the anterior and posterior leaflets) and the adjacent parts of the two leaflets, where one third of the mitral valve can be removed without causing obvious stenosis of the mitral valve.
In this technique, the surgeon removes the commissure and the adjacent infected portions of the leaflets, then attaches the remaining portions of the valve at the cutting edge.
I have performed studies This technique has been shown to be effective in repairing mitral valve stenosis due to septic endocarditis.
This minimally invasive technique is used in cases of coronary stenosis, and it can be performed even before symptoms appear due to its ease of implementation and the lack of complications resulting from it.
In this procedure, a catheter carrying an inflatable balloon at the end is inserted through a vessel in the body into the heart, and when the balloon reaches the site of the mitral valve, it is inflated to widen the opening of the mitral valve.
mitral valve clip (MitraClip)
It is a modern technique to repair the mitral valve using a catheter. Usually, the doctor resorts to this minimally invasive technique in patients with severe mitral valve insufficiency who cannot perform surgery.
In this technique, the doctor inserts a catheter with a clip on its end through a vessel in the body until it reaches the site of the mitral valve, and then uses the clip to connect the two mitral valve leaves together in the middle, so it is also called transcatheter edge-to-edge repair (TEER).
The proximity of the two valve leaflets to each other makes the mitral valve able to close tightly when the ventricles contract, in any case the mitral valve remains open on both sides of the surgical suture, so blood flow continues from the left atrium to the left ventricle when the ventricles are dilated.
Mitral valve repair risks
Mitral valve repair is like other surgeries, as it may carry more risks and complications resulting from the surgical procedure than from the repair itself. These complications include:
- if you
- form blood clots
- Heart attack
- cerebral stroke
- Complications from anesthesia
These risks generally depend on the patient's age, health conditions, and cardiac function.
For asymptomatic patients who underwent coronary heart valve repair, the risk of death during the operation did not exceed one in a thousand, and for asymptomatic patients who underwent the operation, the rate did not exceed 1%, knowing that the patient's coronary artery problems or other problems will affect the risk of the operation.
Benefits of minimally invasive techniques
excel Minimally invasive surgery On open heart surgery Several features, including:
- faster recovery
- Return to everyday life faster
- Shorter hospital stay
- Smaller surgical scars
However not all patients are suitable for minimally invasive surgery, your doctor will tell you the optimal procedure based on your medical history.
What after mitral valve repair?
After the surgeon repairs the mitral valve, he removes the cardiopulmonary bypass machine, restores the heart's pulse, and closes the incision.
After the mitral valve repair surgery is completed, the patient is transferred to the intensive care unit for a day or two, where friends and family can visit their patient.
The patient's vital signs are closely monitored in the intensive care unit, after which he is transferred to a regular room in the hospital where he stays for about 4-7 days until discharge from the hospital.
After discharge from the hospital, it is recommended to follow a healthy lifestyle and not drive a car for at least 3 weeks and not carry heavy weights for 6 weeks, after which all the activities desired by the patient can be carried out.
After the operation, the patient is expected to feel an immediate improvement in the symptoms that he had before the operation, and there will be an improvement in the patient's lifestyle and survival rate.
The recovery time after mitral valve repair surgery varies depending on the type of procedure used and the general health of the patient and adherence to the doctor's instructions, the patient may recover within 4-6 weeks and may take 3 months.
The patient must visit the doctor frequently for the necessary tests and examinations in order to ensure the healing process and the integrity of the mitral valve.
It has proven studies When mitral valve repair was performed on the right patients at the right time, of the 95% patients who underwent the operation successfully repaired the valve and did not need re-operation for 10 years and 90% did not need re-operation for 20 years.
Why should I choose treatment in Turkey?Recently, Turkey has become one of the leading countries in the field of medical tourism in the world.
The reason for this is due to the presence of advanced medical centers that provide appropriate treatment by the most skilled doctors and the latest medical devices at a low cost.
Regarding what has been said, the medical center of Bimaristan Medical Center is your first choice the best treatment in Turkey.
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