Why Choose Cedars-Sinai Marina del Rey Hospital for Mitral Valve Disease Treatment?
The highly skilled surgeons at Cedars-Sinai Marina del Rey Hospital offer multiple treatment approaches for mitral valve disease, including mitral valve repair and mitral valve replacement, depending on the complexity and type of the condition. Thus, by opting for the most suitable surgical procedure for mitral valve disease, the patient’s quality of life will improve significantly and their postoperative discomfort will be reduced as well.
Mitral valve disease is a condition in which the mitral valve that is found between the left chambers of the heart stops functioning in a normal manner. This valve permits the flow of blood from the left atrium to the left ventricle but not vice versa. In patients with mitral valve defects, the blood flows backward into the left atrium resulting in insufficient amounts of oxygen-rich blood being pumped out of the left ventricle to supply the body parts. Symptoms such as fatigue and feeling short of breath may be experienced with mitral valve disease, but most patients, however, may not have any symptoms. If left untreated, mitral valve disease may turn serious as severe cases may lead to life-threatening conditions such as arrhythmia and heart failure.
Mitral Valve Disease Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital
Our cardiovascular surgeons may advise either repair or replacement of the severely damaged mitral valve. During a heart valve repair or replacement surgery, the breastbone is cut through, the heart function is stopped temporarily and the blood is sent through a device called a heart-lung machine. Heart valve surgery is also known as open-heart surgery as it involves the surgical exposure of the heart.
Mitral Valve Repair
Valve repair surgery is performed to correct congenital heart valve defects and has a successful outcome in the treatment of mitral valve defects. The procedures that surgeons follow for valve repair include:
- Commissurotomy: This procedure is performed to repair narrow valves with thickened leaflets that are stuck to each other. The surgeon repairs the valve by cutting down at the points where leaflets adjoin, thus allowing the valve to open properly.
- Valvuloplasty: This procedure is done to provide more support and strength to the valve leaflets so as to allow the valve to close more tightly. This support comes in the form of a special ring-like device that is attached to the outer side of the opening of the valve.
- Reshaping: This involves the removal of a section of a leaflet. Then, once the remaining portions are reattached, the valve closes properly.
- Decalcification: This involves the removal of calcium deposits from the leaflets to allow proper closure of the valves.
- Repair of the structural support: It is done to shorten the cords or chordae tendinae and the papillary muscles to the appropriate length, and provide more support to the valves.
- Patching: This involves covering up the tears in the leaflets using a tissue patch.
Mitral Valve Replacement
In cases where the mitral valve disease turns into a life-threatening condition, valve replacement surgery may be considered.
The two types of valves that can be used for replacement include:
- Biological valves: These can be prepared from animal tissue (xenograft) or taken from the tissue of a donated human heart (allograft/homograft). In some cases, the patient's own tissues are used for valve replacement, which is called an autograft. These valves are not strong enough as mechanical valves and should be replaced every 10 years. These are often used in elderly patients as these tend to break faster in children and young adults.
- Mechanical valves: These are manufactured using materials such as plastic, metal, or carbon. These are stronger and last for a long time. As blood has a tendency to stick to these valves and form clots, patients with these valves are advised to take blood-thinning medications regularly.
Your cardiologist will decide on the most suitable valve replacement based on the severity of your valve defect.
Minimally Invasive Valve Surgery
Minimally invasive heart valve repair or replacement technique involves smaller incisions due to which there will be lesser pain and a shorter recovery period. This type of surgery cannot be performed in patients with the following conditions:
Minimally invasive valve surgery may also be performed using a robot. During robotic surgery, the surgeon makes use of a control console, a side cart having three robotic arms, a special vision system, and certain tools. A computer can translate the surgeon's hand and wrist movements that are made on the control console to the tools that are placed within the patient's body through tiny incisions. The robotic control can interpret even the slight movements made by the surgeon. Robotic surgery reduces the time required to perform valve surgery and shortens your stay at the hospital by ensuring a quicker recovery.
Drugs and Other Treatment Needed for Mitral Valve Disease
Your cardiologist may prescribe certain medications in addition to lifestyle changes. Another less invasive procedure called balloon valvuloplasty is used to repair valve stenosis seen in infants and children.
/Balloon Valvotomy »
Mitral valve disease is classified into three types: mitral valve prolapse, mitral regurgitation, and mitral stenosis.
Mitral Regurgitation »
Mitral Valve Prolapse »
Mitral Stenosis »
Symptoms of Mitral Valve Prolapse
Mitral valve prolapse is not a serious condition, and most patients with this disease may not have any symptoms.
Sometimes, patients may feel palpitations, a skipped heartbeat, or sharp pain in the chest.
Other symptoms include:
- Intense fatigue
- Feeling short of breath, particularly while lying down
- Difficulty breathing after exercise
- Increased heart rate or tachycardia
Symptoms of Mitral Regurgitation
The symptoms of mitral regurgitation appear gradually. These include:
Symptoms of Mitral Stenosis
The symptoms of mitral stenosis tend to become worse with exercise or activity that raises the heart rate. These include:
- Difficulty in breathing after an exercise or at night
- Frequent respiratory tract infections such as bronchitis
- A cough that produces a blood-stained sputum
- Chest pain that aggravates during activity and subsides with rest
- Edema of the foot and ankle
- Hoarse voice
Diagnosis of Mitral Valve Disease
Your cardiologist will initially detect heart valve disease based on signs such as heart murmur and other symptoms. A careful physical examination and supporting results of the diagnostic tests are often needed to diagnose mitral valve disease.
Your cardiologist will listen to your heartbeat using a stethoscope, and detect the presence of a heart murmur. The signs of fluid retention within the body such as ankle edema are checked during a physical examination.
Chest X-ray is done to detect heart enlargement, fluid retention in the lungs, and calcium deposition in the heart. It also helps to find out the type of defect in the heart valve and its severity.
Other Tests and Procedures
It is the major diagnostic test performed to confirm the diagnosis of heart valve disease. A device called a transducer is placed on the chest surface. It transmits sound waves to the heart through the chest wall. Echoes from these sound waves are transformed into a moving picture of the heart that is visualized on a computer screen. This test reveals the size and shape of the valves of the heart and its chambers, and how well the heart is able to pump blood. To get an even better image of the heart, a transesophageal echo may be done. During this test, the transducer is connected to an end of a flexible tube, which is passed down the throat into the esophagus. This enables the production of more detailed pictures of the heart.
This is a simpler test that is able to detect as well as record the heart's electrical activity. It can also detect an irregular heartbeat.
In this procedure, a thin, long, flexible tube is inserted into a blood vessel in the arm, groin, or neck and passed to reach the heart under the X-ray guidance. Your surgeon will perform diagnostic tests and imaging through this tube. These tests reveal how backflow occurs through the valve. This procedure is performed under conscious sedation. Cardiac catheterization is recommended when there is a mismatch between the echocardiography results and the patient's signs and symptoms. It is also done to differentiate whether the symptoms are because of specific valve disease or coronary artery disease.
A stress test can assess the severity of heart valve disease. During this test, the patient is asked to exercise so that his/her heart works hard and beats faster. At this time, various heart tests and imaging are performed.
Cardiac MRI provides more detailed images of the heart and is used to confirm the diagnosis of valve defects.
Risk Factors for Mitral Valve Disease
One of the major risk factors for mitral valve disease is advancing age. The heart valves thicken as age progresses, and become stiff. Patients are at a greater risk of developing heart valve disease if they have past history of diseases such as:
In addition, the risk of heart valve disease is increased in individuals with risk factors for infective endocarditis such as intravenous drug use. Other risk factors include:
Causes of Mitral Valve Prolapse
Mitral valve prolapse is a common type of valve disease and is hereditary in nature. Some kinds of mitral valve prolapse have been noticed in association with Marfan's syndrome, a connective tissue disorder with characteristic long bones and flexible joints.
Causes of Mitral Valve Regurgitation
Mitral regurgitation occurs as a result of conditions that damage or weaken the valve. The common causes of mitral regurgitation in adults are:
- Damage to the mitral valve because of rheumatic fever during childhood
- Injury to the mitral valve following a heart attack
- Injury to the mitral valve due to an infection of the inner lining of the heart (infective endocarditis).
Causes of Mitral Stenosis
Mitral stenosis is caused by any condition that results in the narrowing of the mitral valve. It is commonly caused by rheumatic fever.
Our patients will be advised to seek alternative medicine treatments before we resort to surgical methods of treatment. These include:
Chiropractic care involves a natural, non-invasive therapy that helps in managing heart diseases. It is also helpful in preventing the occurrence of heart diseases.
In order to maintain overall cardiovascular health, it is recommended to perform at least 30 minutes of moderate-intensity aerobic activity for 5 days a week or at least 25 minutes of vigorous aerobic activity for 3 days a week. Performing moderate to high-intensity muscle-strengthening exercises for at least 2 days a week helps in attaining additional health benefits.
Yoga involves stretching your body in different poses while concentrating on your breathing and meditation. Along with a heart-healthy lifestyle, the incorporation of Yoga-based exercises prevents or even reverses heart diseases to a certain extent. One can expect great benefits with Yoga, although it may not be able to completely cure the disease.
In order to prevent mitral valve disease caused by rheumatic fever, it is important to watch for signs of a strep infection and consult your physician immediately. Prompt treatment of these infections can prevent rheumatic fever that causes heart valve damage. It is important to take all the prescribed medicines for the treatment of strep infection. The signs of strep infection are fever, a painful sore throat, and white spots on the tonsils. Additionally, regular exercises, following a heart-healthy diet and lifestyle, and taking medicines that curb cholesterol and prevent heart attack, heart failure, and high blood pressure may also prevent mitral valve stenosis.
For any questions, information, or guidance related to mitral valve disease, consult our specialty-trained, skilled cardiologists at Cedars-Sinai Marina del Rey Hospital.