Mitral stenosis surgery overview

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Mitral stenosis surgery

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Overview

Indications

Treatment

Preoperative Evaluation

Procedure

Recovery

Outcomes and Prognosis

Complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [2]

Overview

Mitral valve surgery can be either a repair for the mitral valve or totally replace it in the heart. Beside percutaneous mitral balloon valvotomy (PMBV), surgical treatments for mitral stenosis include closed commissurotomy, open commissurotomy (valve repair) and mitral valve replacement. In open surgery, the surgeon makes a large cut in the sternum to reach the heart. Minimally invasive mitral valve surgery is done through much smaller surgical cuts than the large cuts needed for open surgery.

Indications

Although mitral valvuloplasty is an effective less invasive treatment modality compared to surgery, mitral valve surgery is indicated if the mitral valve is severely calcified, if there is moderate to severe mitral regurgitation coexists with MS, if mitral valvuloplasty is not available or the patient has unfavorable valve morphology, and if there is left atrial thrombus that persists despite anticoagulation.

Pre-operative Evaluation

The patient may need to have some tests before the procedure. The cardiologist usually conducts a physical examination and diagnose the condition within few days, he or she will assess the general health of the patient and will recommend the most appropriate treatment for the patient and if he or she needs surgery.

Surgical Procedure

The surgery for mitral valve stenosis can be done either by the traditional open heart surgery or by the minimally invasive surgery. Before the surgery, the patient will receive general anesthesia. This causes the patient to be asleep and pain-free during the entire procedure. Beside percutaneous mitral balloon valvotomy (PMBV); there are three approaches for mitral stenosis surgical treatment.

Recovery

The amount of time needed for recovery will depend on the complexity of the procedure, and whether there are any complications. The patient should be closely monitored during the recovery period, whether they are in the hospital, at home, or are being seen in the outpatient setting.

Outcomes and Prognosis

The results of mitral valve stenosis surgery are excellent in centers that regularly perform this surgery.

Complications

Mitral valve surgery carries the same risks as any surgical procedure, such as DVT, post-operative infections, and adverse reactions to anesthesia. The risks that are specific to open-heart surgery are; heart attack, stroke, arrhythmias, and sternal wound infections. Prosthetic heart valves themselves are also associated with a number of complications.[1]

References

  1. Ramlawi, Basel; Gammie, James S. (2016). "Mitral Valve Surgery: Current Minimally Invasive and Transcatheter Options". Methodist DeBakey Cardiovascular Journal. 12 (1): 20–26. doi:10.14797/mdcj-12-1-20. ISSN 1947-6094.

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