Surgery for mitral valve leakage

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Submitted by Dr T on October 28, 2013 – 11:31am

Question: 
Hi, my question is regarding mitral valve surgery.  I see that most recommendations say only when your mitral valve has severe regurgitation, but that appears to be controversial. If your have moderate regurgitation with a mildly dilated left ventricle and mild tricuspid regurgitation would that still warrant surgery?  I would think that once the valve starts affecting the pumping of the heart it would need to be fixed, especially when you are in your early 40’s. Any thoughts you have would be appreciated.  Thanks.

Hi Dianne,

You are quite right that once the heart function is affected by mitral valve leakage, it may be soon necessary to consider a mitral valve repair. However, the precise timing of an operation is always a question of judgment. I would look at the rate of change in heart function, f.i. between the last few evaluations. This is usually done with serial echocardiograms. If none, I’d probably recommend against surgery for now.

If a significant change is present since the previous test, I’d consider surgery at this point to prevent worse. As far as the operation itself is concerned, it should be a disease specific mitral valve repair, not a valve replacement if at all possible:

This requires a surgeon with extensive experience!

Hope this helps,

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