Heart - Cardiology & Cardiovascular Surgery

Mitral Valve Surgery

Mitral valve surgery is inclusive of both mitral valve repairs and replacements. At Mount Sinai Heart, our goal is to perform a mitral valve repair, rather than replacement whenever possible.

Typically we treat mitral valve disease through open-heart surgery; however, depending on the individual case a minimally invasive approach may be possible. When performing minimally invasively, our surgeons use specifically designed instruments passed through a few tiny incisions and into the heart.

Many times, mitral valve regurgitation is caused by a weakening of the mitral valve's posterior leaflet. This weakening causes the valve to swing back and forth like saloon doors, unable to shut properly. In this situation, we remove the weakened portion of the leaflet, which enables the valve to close normally and avoid leakage.

Mitral Valve Repair

At Mount Sinai Heart, we try to preserve as much of the valve as possible, preferring to repair rather than replace the valve. Mitral valve repair offers improved life expectancy, better preservation of heart function, and lower risk of endocarditis than with valve replacement. Additionally, if you receive a repair procedure, you can often avoid taking anticoagulation medications long-term. At the Mitral Valve Repair Reference Center at The Mount Sinai Hospital, our mitral valve repair (99 percent) and quality (less than 1 percent mortality) rates are national benchmarks. Often, we apply one of two techniques: removing part of the valve and using annuloplasty rings.

To perform mitral valve repair, our surgeons often perform extensive reconstruction of the valve leaflets, using sutures to support the valve. After fixing the leaflet, we implant an annuloplasty ring around the valve to reinforce the annulus. The annulus frames the valve much the same way a door frame supports a door. Annuloplasty rings help restore the annulus to its normal size and shape if it has become enlarged or distorted.

Mitral Valve Replacement

In some valvular heart disease, the valves are significantly calcified or damaged by infection. When we cannot manipulate and repair the tissue, we must do a mitral valve replacement. Our surgeons use either mechanical devices or biological valves, called heterografts, which are made from animal tissue and strengthened with metal frames.

Replacement valves are subject to various risks:

  • Valves can deteriorate, causing openings to narrow or leak.
  • Blood clots can form near the new valves and break off.
  • Anticoagulant medications, given to prevent clots, can cause bleeding.
  • Infection, such as endocarditis, can develop.
  • Structural valve failure may require repeat surgery.