Mitral valve annuloplasty

Mitral Valve Annuloplasty is a surgical procedure aimed at treating mitral valve regurgitation, a condition where the mitral valve in the heart does not close tightly, allowing blood to flow backward in the heart. This procedure involves the repair of the mitral valve's annulus, which is the ring-like structure that supports the valve. Mitral valve annuloplasty is considered when the mitral regurgitation is severe and symptomatic, and it is designed to improve the function of the mitral valve and reduce or eliminate the regurgitation.

Indications[edit | edit source]

Mitral valve annuloplasty is indicated for patients with symptomatic severe mitral regurgitation due to a variety of causes, including mitral valve prolapse, rheumatic heart disease, and endocarditis. It is also indicated in patients with asymptomatic severe mitral regurgitation with signs of left ventricular dysfunction, pulmonary hypertension, or new onset of atrial fibrillation.

Procedure[edit | edit source]

The procedure is typically performed under general anesthesia through a median sternotomy, where the chest is opened in the middle. Cardiopulmonary bypass is required to maintain the circulation during the surgery. The surgeon accesses the mitral valve and assesses its structure and the extent of the damage. Depending on the findings, the surgeon may perform a ring annuloplasty, where a prosthetic ring is sewn around the annulus to tighten it, or a suture annuloplasty, where sutures are used to reshape and stabilize the annulus. The goal is to restore the normal shape and size of the mitral valve annulus, thus ensuring better coaptation of the mitral leaflets and reducing regurgitation.

Risks and Complications[edit | edit source]

As with any surgical procedure, mitral valve annuloplasty carries certain risks and complications. These may include bleeding, infection, stroke, heart attack, and the need for a repeat surgery. There is also a risk of prosthetic ring dehiscence, where the ring detaches from the annulus, and heart rhythm disturbances.

Recovery[edit | edit source]

Postoperative recovery involves a stay in the intensive care unit (ICU) for close monitoring, followed by a period of recovery in the hospital. The total hospital stay can vary from a few days to a week, depending on the patient's overall health and the presence of any complications. Full recovery and return to normal activities can take several weeks to months. Patients will need to participate in cardiac rehabilitation and follow-up with their cardiologist for regular check-ups.

Outcomes[edit | edit source]

The outcomes of mitral valve annuloplasty are generally positive, with many patients experiencing significant improvement in their symptoms and quality of life. The procedure has a high success rate in reducing or eliminating mitral regurgitation and improving heart function. However, long-term outcomes depend on the underlying cause of the mitral regurgitation, the presence of other heart conditions, and the patient's adherence to postoperative care and lifestyle modifications.

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