Minimally Invasive Mitral Valve Reconstruction
What is the probability of minimally invasive mitral valve reconstruction?
The probability is approximately 60-80%. When a patient requires mitral valve surgery for degenerative valve disease, our clinic usually performs these interventions with a 5-7 cm skin incision. Preoperative testing allows us to determine the safest approach for each patient. In mitral valve surgery, we give preference to an incision that is performed in the right intercostal region.
There are several methods of minimally invasive surgery. Minimally invasive techniques can be used to perform aortic and tricuspid valve surgery alone, or in combination with mitral valve surgery.
The advantages of minimally invasive approaches include: faster recovery time, reduced pain, reduced need for blood transfusions, and improved cosmetic results. Before minimally invasive surgery is performed, we evaluate and thoroughly examine each patient to choose the best and safest method of treatment.
Surgical treatment methods
Posterior valve leaflet problems are often corrected with a small number of Neochords (artificial chords) or a small resection of the abnormal portion of the leaflet. Anterior leaflet dysfunction is usually corrected in most cases by the use of Neochords or chord transplantation. Reconstruction of the anterior leaflet is technically more difficult. An experienced and specialized surgical team is required to achieve good results. To all reconstructive valve surgery, annuloplasty is also added. An annuloplasty ring is a complete or partial ring placed around the circumference of the valve.
Posterior valve leaflet prolapse
During mitral valve plasty, triangular resection is the most commonly used technique for posterior leaflet prolapse.
Mitral valve repair by triangular resection
The free end of the posterior valve leaflet shows torn chords. The portion to be resected is marked with a dotted line.
The damaged segment has been removed. The edges of the cusps are sutured together.
Reconstruction of the valve is completed by annuloplasty.
Anterior valve leaflet prolapse
The process of anterior leaflet prolapse repair is more complex and requires a lot of surgical experience. To repair anterior valve leaflet prolapse resulting from a ruptured or lengthened chord, we create new Gore-Tex chords in most cases. The Gore-Tex chords remain in the patient permanently. The second method used to repair anterior valve leaflet prolapse is the chord transfer technique, which involves moving a chord from another part of the valve to the area with the damaged chords. Both of these methods give good long-term results.
Gore-Tex chord used to repair valve leaflet prolapse
Chord, after reconstructive surgery
The Gore-Tex chord is first sewn to the head of the papillary muscle and then guided through the free edge of the anterior valve leaflet to ensure proper valve closure.
The long-term endurance rate is very high. The new chords do not tear or stretch.
Chord transplantation for treatment of anterior valve leaflet prolapse
Posterior valve leaflet chords are transferred to the unsupported edge of the anterior valve leaflet. Posterior valve leaflet repair is then performed. The process of valve repair is completed by annuloplasty.