Mitral Valve Repair Complications

Mitral valve repair is the most common type of valve surgery. About 99,000 such surgeries are performed each year in the U.S. According to Dr. A. Marc Gillinov of the Cleveland Clinic, heart surgeons are able to repair the majority of valves, rather than replace them.

The Importance of the Mitral Valve

• The mitral valve is on the left side of the heart, which works harder than the right side to circulate blood throughout the body. The mitral valve allows blood flow from the left atrium (top chamber of the heart) to the left ventricle (bottom chamber). If the valve doesn't function properly, the pressure inside the left ventricle can lead to heart failure.

  Causes of mitral valve problems may be caused by infections, heart attacks, heart disease or birth defects. Minor problems may be treated with medication and medical management.

Assesing Mitral Valve Function

• Several tests are used to determine how well the mitral valve is working. A physical exam is performed to determine if there are any abnormal heart sounds, such as a murmur, caused by mitral valve problems.

  Other tests may be needed for a definitive diagnosis, such as an EKG to assess the heart's electrical activity. Chest x-rays reveal if the heart is enlarged or has calcium buildup. X-rays also show if there is any fluid in the lungs. An echocardiogram, or echo, uses sound waves to show the heart in real time as it beats. This shows the actual flow of blood through the valves and is commonly used to diagnose valve problems.

  Stress tests evaluate how well the heart works with strenuous exercise. An MRI uses a very strong magnet and radio waves to make detailed pictures of the heart.

Invasive Testing

• A TEE (transesophageal echocardiogram) involves passing a tube into the esophagus to get a better image. A heart cath (cardiac catheterization) may be ordered and involves threading a thin tube into the heart through the groin. This allows the doctor to record pressure changes in the heart, evaluate any backflow from the valves and see how well the valves open and close.

Complications of Mitral Valve Repair

• Like all surgeries, mitral valve repair involves risk. Smokers tend to have more complications with bleeding and breathing. All surgeries carry a risk of infection at the operative site, blood clots, reactions to anesthesia and death. No surgery can be guaranteed to be 100 percent risk-free. Obese patients also have a higher risk of complications.

Complications Specific to Mitral Valve Repair Surgery

• The complications specific to mitral valve replacement surgery includes the risk from the heart-lung bypass machine used when laporascopic surgery is not feasible. These include death, stroke, heart attack, irregular heart rhythms, kidney failure and lung problems.

  If there are complications, patients may have a longer hospital stay, require blood transfusions, further surgery and dialysis if kidney failure develops. Fortunately, the risk of serious complications is low, and overall the mortality rate associated with mitral valve repair surgery is low.

  Following surgery, patients are at increased risk for infection in the valves. Long-term antibiotics are used to prevent infection. Patients should always inform their dentist before having any dental work done or any other surgeries. Home care instructions should be followed, including follow-up appointments.