Key Hole Surgery-Repair/ Replacement Of Heart's Mitral Valve

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Traditionally, repair or replacement of Mitral Valve is done by open surgery which involves cutting
into the chest to get to the heart. There may be a long recovery time because the separated bone needs to heal. Treatment of Mitral valve disease depends on the severity of your condition.
When heart valves begin to fail, the heart beats harder to make up for reduced blood flow. As the heart beats harder, symptoms of valve disease may occur including -
1) Shortness of breath or difficulty in catching your breath.
2) Palpitations.
3) Swelling of feet, Ankles or Abdomen.
4) Weakness or dizziness
5) Quick weight gain
6) Discomfort in chest.

 In key hole surgery, small cuts are made in the chest wall between the Ribs. A Camera and Monitor
are inserted through one of the cuts. By watching what is happening on the monitor, the Surgeon performs the operation to repair the Mitral valve using special instruments inserted through the remaining holes. The medical name used is 'Thoracoscopic Surgery'. Both open and Key hole surgery are carried out under General Anaesthesia. A Bypass machine does the work of Heart and Lungs while the heart is stopped during the operation.
Mitral valve repair and its replacement are procedures that may be performed to treat diseases of the Mitral Valve - valve located between the left Heart Chambers (Left Atrium and Left Ventricle).
Several types of Mitral Valve disease exist.
In Mitral Valve Regurgitation, the Flaps (leaflets) of Mitral Valve don't close tightly, causing blood to leak backward into the Left Atrium. This commonly occurs due to valve leaflets bulging back - a condition called Mitral Valve Prolapse.
In another condition, called Mitral Valve Stenosis, leaflets become thick or stiff, and they may fuse together. This results in a narrowed valve opening and reduced blood flow through the valve.

Treatment of Mitral valve disease depend on the severity of your condition. Doctor may first suggest
monitoring your condition with regular evaluations. If you are not experiencing symptoms or your condition is mild, you may be prescribed medications to manage symptoms. If your condition is mild
you may not need surgery. 
 
The Heart has four valves that keep blood moving in the correct direction around the body. Oxygen-Rich blood flows from lungs and through the Mitral valve into the heart's main pumping chamber, the Left Ventricle. When the heart squeezes, the Mitral valve closes so blood does not flow backwards into the Lungs. Sometimes, the Mitral valve stops working properly, it may leak allowing blood to flow backwards into the lungs. This causes shortness of Breath and eventually, heart failure (when the heart cannot pump enough blood to meet the body's needs). Less commonly, the Mitral valve cannot open properly and this can prevent blood from flowing into the heart from lungs.
Diagnosis -
First step involved is listening with Stethoscope. With this, Doctor hears a murmur which represents turbulent blood flow across an abnormal valve. It is confirmed by ECG. Ultra sound is used in an ECG to visualize the heart valves and determine the severity and cause of the leak. Sometimes a Transesophageal ECG ( a probe passed through the mouth into the Esophagus) is necessary to more closely visualize the valve.
Mitral valve Prolapse is a common condition in which the valve leaflets are floppy or loose.. It is diagnosed by ECG. Most patients with Mitral valve prolapse do not have a leaky valve and do not require surgery which should be considered only in case of severe leakage.

Most surgeons can do a valve replacement in less than one hour but a complex valve can take up to two hours longer.



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