Mitral Valve Repair and Replacement

If you have been diagnosed with a mitral valve condition, you’ll be glad to know that the Northwest Regional Heart & Vascular Center is home to one of Portland’s most experienced surgeons in treating this condition.

Thomas Molloy, MD, is nationally recognized for his expertise in minimally invasive and robotically assisted cardiac surgery. As a result, his patients experience a shorter hospital stay, less pain and scarring, reduced need for blood transfusions, and a faster return to normal activities than with traditional open-chest surgery.

What is mitral valve disease?

The mitral valve lets blood flow from one chamber of the heart (the left atrium) to another chamber called the left ventricle and prevents it from flowing backward (regurgitation). It’s also referred to as the bicuspid valve because it consists of two tapered flaps, also called “leaflets.”

There are two main types of mitral valve disease:

• Mitral valve regurgitation, in which the leaflets do not close tightly, allowing blood to leak backward (regurgitate) into the left atrium. The most common cause of regurgitation is mitral valve prolapse, in which the flaps bulge back into the left atrium.
• Mitral valve stenosis, in which the mitral valve leaflets become thick or stiff, or even fuse together, resulting in a narrowed valve opening and reduced blood flow.

How is mitral valve disease surgically treated?

There are two types of surgical treatment for mitral valve disease: valve repair and valve replacement.

Mitral valve repair: More than 94% of mitral valve cases referred to us can be repaired instead of replaced. This gives patients the best chance of restoring normal heart anatomy and function. Repaired valves also resist infection better than a valve replacement and do not require anticoagulant treatment (blood-thinning medication) after surgery.

Thanks to our minimally invasive techniques, our mitral valve repair patients typically stay in the hospital about half as long as the national average. Explore more data about our outcomes.

Mitral valve replacement: When a valve has been damaged by rheumatic fever or is heavily calcified, the faulty valve and its supporting structures must be removed and replaced. Heart valves can be replaced by mechanical (artificial) valves or valves made from animal tissue (biological valves).

• Mechanical valves typically do not wear out. People with mechanical heart valves, however, must take an anticoagulant medicine for the rest of their lives to keep blood clots from forming on the valve.
• Biological valves are usually made from cow (bovine) or pig (porcine) tissue. They are less likely to cause clots. These valves are less durable, however, and young patients may require another replacement later in life.

Because of our techniques and expertise, our patients who undergo mitral valve replacement typically stay in the hospital several days less than the national average. Explore more data about our outcomes.

Your surgeon will discuss the pros and cons of each type of valve. You’ll decide together which type of valve is best for you.

Surgical approaches for mitral valve surgery

There are two surgical approaches for performing mitral valve surgery.

Minimally invasive, robotic valve surgery: The state-of-the-art da Vinci surgical robot is used by the surgeon to perform mitral valve surgery through much smaller incisions and with greater precision. This contributes to our team’s high success rate that includes fewer complications, a shorter hospital stay, less pain and blood loss, and a faster recovery compared to traditional open-chest surgery.

Open-chest surgery: This approach may be necessary for patients who need multiple valve repairs or replacements or a simultaneous coronary bypass procedure. The surgeon makes an incision down the center of the chest and divides the breastbone for direct access to the heart. A heart-lung bypass machine temporarily performs the work of the heart while the surgeon replaces or repairs the faulty valve. The open-chest approach is rarely needed for standalone valve surgery.

Both procedures require a hospital stay; how long depends on the procedure and your overall health.

Which mitral valve procedure and surgical approach are right for me?

The most appropriate treatment depends on the type and extent of valve disease you have, along with other factors such as your overall health. Similarly, the most appropriate surgical approach will be based on careful evaluation of your individual situation.

View our quality data for mitral valve surgery.

To learn more about Dr. Molloy and his team’s approach to Mitral Valve Repair and Replacement, call us at 503-261-4430.