Mitral valve replacement
Replacement of the mitral valve located between the left atrium and left ventricle is among the most frequent heart surgeries. Poorly working mitral valve prevents the return blood flow (regurgitation) to the atria, which can lead to its stretching, deformation, arrhythmia, heart failure and other disorders. Replacement of the mitral valve is indicated with its expressed disorders that cannot be restored by conservative treatment or valve repair.
When mitral valve surgery is needed
The mitral valve directly participates in the process of pumping blood and is constantly exposed to significant blood pressure. Mitral valve is most prone to pathologies and defects among other parts of the heart. Valve insufficiency is the condition when the mitral valve does not close tightly preventing normal blood circulation and forcing the heart to work with increased load. The causes of this dysfunction have not yet been fully studied. They can be:
- connective tissue disorders, such as dysplasia, manifested in increased tissue flexibility;
- previous infectious disease resulted in inflammation of the inner heart lining, which covers its valves. Connective tissue develops in the valve creating scars and adhesions, which partially block the entrance to the atrium;
- pathology of the myocardium and heart muscles fixing the valve;
- deposition of mineral salts on the valve walls;
- rheumatism and other causes.
In the early stages, mitral insufficiency is treated with conservative methods combined with diet and moderate exercise. In more complex cases surgical repair of the mitral valve with pathological changes may be needed. Replacement of the mitral valve of the heart is necessary under the following indications:
Replacement of the mitral valve of the heart is necessary in the presence of the following indications:
- when it is impossible to provide effective surgery for opening of adhesions between valves (commissurotomy);
- severe fibrosis (formation of a thick layer of connective tissue) of the valve;
- severe valve calcification (calcium deposits);
- shrinkage of the valve and tendon threads
Details of the mitral valve replacement surgery
Mitral valve prostheses can be mechanical, made of silicone, metal and other materials, or biological, made of the cardiac muscle tissues of cattle, horses or pigs. The service life of the mechanical valve is not limited, but it requires lifelong use of anticoagulants to prevent the formation of blood clots. The biological prosthesis needs to be replaced over time (usually after 10-15 years) because it is prone to calcification and wear. Currently mitral valve repair surgery or replacement with with prosthesis is performed on an open heart or by a minimally invasive method. In the former case, the operation takes about 6 hours. It is performed under general anesthesia and includes the following stages:
- median sternotomy, when a large incision is made in the chest and the patient is connected to the circulatory system;
- removal of the damaged mitral valve;
- installation of a mechanical or biological implant;
- suturing of surgical wounds;
- gradual disconnection of the patient from the circulatory system.
The minimally invasive method involves replacing the valve without opening the chest and connecting to the circulatory system. A small incision is made through which the implant together with a fiber-optic probe is installed into the heart cavity. The surgery process is controlled on the display.
The Cardiac Surgery Center of the Dobrobut Clinic in Kyiv is actively implementing minimally invasive methods for surgical repair or replacement of the mitral valve. The price of minimally invasive surgery or annuloplasty in Ukraine is much lower than for similar services in the United States, Europe and even Israel. Advanced techniques, state-of-the-art medical equipment and experienced specialists (cardiologists and cardiac surgeons) are the main advantages of the Dobrobut clinic. You are welcome to make an appointment with a cardiologist right on our website!
The network of Dobrobut clinics has a patient support service, which provides care and support after discharge, records the patient's health, and schedules routine examinations by a specialist after treatment.
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At the Dobrobut Cardiac Surgery Center, patients receive:
- the full range of heart surgery in patients of all ages: from babies in the first year of life to people aged 90 and over;
- minimal risk of heart surgery. Since December 2016, the center has performed more than 1,100 cardiac surgeries, including complex multicomponent ones, with a mortality rate of 0.6%, which is five times less than the average in Ukraine;
- 80% of all heart surgeries are performed minimally invasively: without incision of the sternum, through the intercostal access of 5-7 cm. This is the largest percentage among cardiac surgery centers in Europe. All isolated operations of coronary artery bypass grafting, operations on mitral, aortic, tricuspid valves and aorta, removal of heart tumors, closure of atrial and interventricular septal defects, operations on Fallot's tetrad are performed minimally invasively;
- Dobrobut Cardiac Surgery Center is an expert center for mitral valve plastic surgery. More than 70 operations on minimally invasive mitral valve surgery are performed annually (according to European recommendations, the annual number of operations should be at least 50 to maintain the expert level).
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