Pathology:
The Mitral Valve is located between Upper Chamber (Left Atrium) and Lower Chamber (Left Ventricle). Being a one way valve, it regulates flow of blood in one direction, that is from Left Atrium to Left Ventricle. However, in certain diseases or degenerative conditions (Mitral Valve Prolapse), the Mitral Valve malfunctions letting blood flow back into Left Atrium (Mitral Regurgitation).
Complications:
- Mitral Regurgitation: The Mitral Valve has 2 leaflets which normally open & close to allow one way passage of blood from Left Atrium to Left Ventricle. The leaflets are connected to muscles of Left Ventricle by string like structures (Chordae Tendineae). These cords control movement of both leaflets. Due to perforation; lengthening; or shortening of one of the leaflet or elongation; shortening; or rupture of the Chordae, the Mitral Valve is unable to close completely. As a result, blood leaks back into the Left Atrium leading to increased back-pressure in the heart and lungs causing Palpitation and Breathlessness.
Treatments:
The usual investigations needed to diagnose and plan treatment for Mitral Regurgitation are 2D Echo and Transoesophageal Echocardiography. In patients above 40 years of age, Coronary Angiography is required to identify Coronary Artery Blockages. This condition is corrected by procedure called “Mitral Valve Repair (MV Repair)”. The defective Mitral Valve is repaired using any of following procedures.
- Insertion of Cloth covered metal ring to ensure proper closure of Leaflets (Ring Annuloplasty)
- Removal of excess or lose segment of leaflets (Quadrangular Resection)
- Re-suspension of Leaflets with artificial Cords (Neo-Chordae)
Salient Features of Mitral Valve Repair Surgery
- As compared to Mitral Valve Replacement (MVR), the patient does not require blood thinners. This is due to the fact that native valve itself was repaired.
- Patients display significant symptomatic improvement after Mitral Valve Repair Surgery.
- In some cases, where Coronary Artery blockages are observed along with Mitral Regurgitation, both Coronary Artery Bypass Grafting (CABG) & Mitral Valve Repair (MV Repair) Surgeries can be performed simultaneously.
