Mitral Valve Repair

The mitral valve is a complex structure that controls blood flow through the left side of the heart. When open, the mitral valve allows blood to flow into the heart’s main pumping chamber, the left ventricle. When the left ventricle contracts to push blood through the body, the mitral valve closes to prevent blood from flowing back toward the lungs.

Sometimes the mitral valve is abnormal from birth or becomes damaged by infection. More often, mitral valve structures become damaged with age or from coronary artery disease.

Whatever the cause, an abnormal or damaged mitral valve cannot completely seal the heart’s left ventricle. With an incomplete seal, blood can escape the left ventricle and flow backwards through the mitral valve. This conflicting force can make the heart work harder, leading to further mitral valve damage and other potential complications such as congestive heart failure.

Surgical Mitral Valve Repair

Mitral valve surgeries have always been a staple of modern cardiac surgery. However, until now, the only way to either repair or replace a heart valve was to open the chest of the patient and put them on a heart-lung oxygenator. Surgical repair involved delicate reconstruction of native valve tissues in order to restore proper function. The most common approach to repair requires the surgeon to saw open the breastbone and spread the ribs to gain direct access to the heart.

Cutting the sternum and opening the rib cage — the body’s natural protective structure for the heart — can prolong healing time, increase risk of infection, serious complications and even mortality.

Robotic Mitral Valve Surgery

Mitral valve repair is one of the first cardiac surgical operations performed with the da Vinci system and for which FDA approval was obtained. Pioneered in Europe and further refined in the United States, repair of leaking mitral valves due to myxomatous disease, chordal rupture, or annular dilatation, exploits the technical advantages provided by the da Vinci system. The mitral valve can be accessed by a small 6 to 8 cm right thoracotomy and two 1 cm instrument ports, without opening the sternum and rib cage. Excellent visualization of the mitral valve with the da Vinci robotic camera system is usually obtained, greatly facilitating its repair. Posterior quadrangular resections and/or "sliding-plasty" repairs are generally performed.  Robotic arms can be manipulated inside the cavity, performing operations that may otherwise be too difficult, whether because of physical abnormalities are misfortunate location.

If you are a patient with isolated mitral insufficiency who would like to be evaluated for this minimally invasive approach to mitral valve repair, please contact our office [link].  If you are considering having your heart surgery at St. Luke’s, Methodist, or Memorial Hermann, please contact us.