Minimally Invasive Mitral Valve Surgery For Resolving Insufficiency
Blood flows into your left atrium from your lungs
. As electrical signals spread across the surface of the atrium, the chamber contracts and pushes blood through the mitral valve (MV) into the left ventricle. The signal then spreads across the ventricle and causes it to contract. When it does, blood is pushed out into the aorta, an artery that carries it to the rest of your body.
If the mitral valve is diseased, blood may be unable to move efficiently between the left atrium and left ventricle. Because your body depends on receiving oxygenated blood from your heart, this can lead to a number of ancillary problems.
One of the disorders that can impair the function of the valve is known as mitral insufficiency (also called regurgitation). Below, we'll describe this disease and explain the factors that cause it. You'll also learn how the problem can be corrected through minimally invasive mitral valve repair surgery.
What Is Mitral Insufficiency?
Your MV consists of two leaflets. When the atrium begins to contract, the leaflets open to allow blood to flow into the ventricle. Once the atrium has finished its contraction, the leaflets close. This prevents blood from flowing back into the atrium when the ventricle contracts.
With mitral insufficiency, the two leaflets fail to close completely. Because the passage between the upper and lower chambers remains open, blood is allowed to flow backward. When the ventricle begins to contract, some of the blood is pushed outward into the aorta (as it should be) while some is pushed back into the atrium. This creates a number of issues.
First, the upper chamber might begin to expand in order to accommodate the increased volume of blood. Second, the backflow creates excess pressure on the lungs. Third, less oxygenated blood is available for your organs and tissues.
If the condition is mild, you may not experience any symptoms. If it is advanced, however, it can cause atrial fibrillation, fatigue, chest pain, and clotting within the atrium.
What Causes The Insufficiency?
Mitral insufficiency can be caused by a few different factors. Coronary artery disease can contribute to the condition by restricting blood flow to the heart. Cardiomyopathy can also contribute by causing the lower chamber to weaken. This stretches the MV and prevents the leaflets from forming a secure seal. Occasionally, an infection can damage the valve's leaflets and make them incapable of closing properly.
The most common cause of mitral insufficiency is myxomatous degeneration. This is a condition where the connective tissue of the MV weakens. It is usually referenced in the context of prolapse, a circumstance where one of the leaflets (anterior or posterior) flops back into the atrium.
How The Problem Is Resolved
An insufficient MV can be resolved through minimally invasive mitral valve repair surgery or by replacing the valve. Of the two options, repairing the valve is usually preferred. This is because the introduction of an artificial replacement - biological or mechanical - usually means the patient must take blood thinners for the remainder of his or her life.
Repair surgery can be done using different approaches based on the nature of the insufficiency. For example, if prolapse exists, a surgeon can perform a triangular resection or chordal transfer, depending on which leaflet is diseased. Otherwise, the surgeon can perform valvuloplasty and annuloplasty to eliminate the problem.
These procedures can often be done through a keyhole incision rather than cutting into the patient's chest and "cracking" the breastbone. As a result, the recovery period is usually shorter and accompanied by less postoperative pain. There is also less likelihood of infection.
Not everyone is a viable candidate for minimally invasive mitral valve repair. If you suffer from mitral insufficiency, speak with your physician regarding your surgical options.
by: Cindy Richmark
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