Endoscopic Mitral Valve Repair

Who needs a mitral valve replacement?

If the valve has become stiff due to calcium build-up this can ultimately prevent blood flow from your heart to the rest of your body. Another factor for mitral valve repair could be if the flaps are not opening and closing tightly enough which allows the blood to flow backwards into the left atrium, this is called regurgitation. A patient who has mitral valve disease or mitral valve stenosis may be recommended for surgical intervention.

Your condition will be evaluated by your surgeon and his team, taking in to account your symptoms and severity. The risks and benefits will be talked through with you in great detail along with an explanation on what the surgery is, why and how it is performed and what will happen after.

If you are due to undergo endoscopic mitral valve repair then we hope this blog will be helpful and informative. You will be placed under general anaesthetic for the duration of the procedure which can usually take up to 4 hours.

There are different ways in which a mitral valve can be repaired, three of the most common ways are:

• Annuloplasty – A ring/band is sewn round the already existing band (annulus) to reinforce its shape, tightness and to stop blood from leaking backwards.
• Valvuloplasty – Known as a balloon valvuloplasty, a catheter with a balloon tip is guided in to the valve using x-ray guidance. The balloon is inflated to widen the valve leaflets to improve blood flow. No cuts to your chest will be made as the catheter will be inserted through your groin. The balloon and catheter are then removed.
• Valve repair – To rebuild, shape and trim the calcified leaflets so they can open and close as normal allowing normal blood flow to your body.

In endoscopic surgery, an x-ray is used to mark the ribs so the surgeon can make up to 4 small holes in-between them. This means we don’t cut through the breastbone (sternotomy). Endoscopic cardiac surgery constitutes an invaluable alternative to sternotomy with the same gold standards of results and quality, but with much better cosmesis and patient satisfaction.

Of course, with any surgery there are risks attached but far fewer than open surgery. Here are some possible risks:

• Wound infection
• Damage to other bones, organs or nerves
• Irregular heartbeat
• Stroke

However, the benefits far outweigh the risks and your surgeon will go through all the risks and benefits with you prior to your operation. Some of the benefits of endoscopic surgery versus open heart surgery are:

• Lower risk of infection
• Less noticeable and smaller scars
• Faster recovery in hospital and able to return to normal activities quicker
• Less blood loss
• Reduced pain

• Postoperatively, you will be placed on an ICU ward with close observations. Pain relief medications will be given such a codeine and Tramadol. It is possible to have early mobilisation, as soon as the patient is ready and discharged from hospital on the third day. It is estimated that after four weeks you will be able to return to normal activities and flying.