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Valve Repair
Valve disease can be treated with surgery. Clinical research has determined that valve repair is preferable to replacement. When repair is performed by a highly skilled echo/surgical team, it leaves the patient’s own living tissue functioning normally. The aortic, tricuspid and mitral valves can be repaired, although most of the documented advantages listed below are for mitral valve repair.
- A lower mortality at the time of operation (no repair deaths at Hoag for years 2000-2005 compared to national mortality rate 4-6% for replacement.)
- A significantly lower risk of stroke, and a lower rate of infection.
- Better long-term survival with mitral valve repair.
- After mitral valve repair, blood thinners are not required, in contrast to the life-long requirement for blood thinners after mechanical mitral valve replacement.
- Mitral valve repairs are very durable. Studies have shown that 95 percent of patients will have a working valve 20 years after mitral valve repair surgery.
Successful repair requires a dedicated echo/surgical team. Mitral valve repair is technically more difficult than replacement and the operative success is dependent on the specific type of valve condition and the collaboration between the cardiologist with echo expertise and the skill of the cardiac surgeon. The echo/surgical team at the Hoag Heart Valve Center is recognized experts in complex mitral valve repair and are able to repair 95 percent of all mitral valves. This is a significant accomplishment since the national repair rate is 50 percent according to the Society of Thoracic Surgeons (STS).
One of the reasons mitral valve repair is difficult and requires close collaboration is that each valve is different and requires a unique operation. There is a range of common techniques used, but the combination and the optimal application of the techniques are unique to each repair procedure.
Shown below is one of the common techniques used for mitral valve repair:
Mitral Valve Repair by Posterior Leaflet Resection: The prolapsed portion of the posterior leaflet is removed and the leaflet is sewn back together, allowing the valve to close more tightly. An annuloplasty ring is then secured to keep the annulus from dilating.
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