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Medical Video: Right Thoracotomy Approach For Minimally Invasive Mitral Valve Surgery
Making the decision to undergo mitral stenosis surgery needs to be accompanied by the selection of the right time and the appropriate case. If you and your doctor have determined the time for the procedure, you will then determine the 3 main choices for your mitral stenosis surgery.
The most recommended options that are not recommended are:
- Percutaneous Mitral Balloon Valvulotomy (PMBV)
- Mitral Commissurotomy
- Mitral valve replacement
Not all patients with mitral stenosis can be suitable candidates for these choices.
Percutaneous Mitral Balloon Valvulotomy
In mitral stenosis, a flexible valve that opens and closes when the heart contracts (mitral valve) often joins together, causing the valve to not fully open. PMBV will separate valves from one to another to relieve the disorder.
In PMBV, a thin and flexible tube (catheter) fitted with a balloon that is still deflated will pass through the mitral valve. The balloon will then be developed to separate the mitral valve from each other.
Because PMBV is not an open surgery, this process is far less painful than other forms of mitral valve surgery.
Complications are relatively minimal and the recovery process is quite easy. PMBV is very effective if done in the right patient.
In general, PMBV is a surgical procedure that your doctor will recommend to treat your mitral stenosis unless you have:
- Atrial thrombus left (blood clotting)
- Calcium deposit around the mitral valve
- Medium to severe mitral regurgitration - when the mitral valve is not closed properly, leakage can occur through the valve
As an illustration, PMBV is usually not an option if your mitral stenosis condition is a congenital condition, because you probably have a complicated heart anatomy.
Mitral stenosis can return badly after PMBV. For this reason, after undergoing the procedure, it is important to keep conducting routine evaluations. 21% of patients who have PMBV need a second treatment.
Mitral Commissurotomy
The purpose of Mitral Commissurotomy is the same as PMBV - to separate valves from one another. The difference is, mitral commissurotomy is an open heart procedure that uses a scalpel.
Results commissurotomy usually good, but you have a risk of major surgery and a long recovery time, so doctors do not recommend it as a top choice.
Commissurotomy is a good choice for prospective PMBV candidates, unless there is atrial thrombus left, calcification or mitral regurgitation.
Similar to PMBV, mitral stenosis can occur again after commissurotomyso that patients undergoing this procedure require regular evaluation.
Mitral Valve Replacement
Mitral valve replacement is the last choice, because it has a higher risk of complications than PMBV or commissurotomy. Valve replacement is needed if mitral stenosis has caused the valve to be damaged and calcified, so that the previous two procedures cannot be performed.
In mitral valve replacement, the valve is replaced with an artificial valve (prosthetic). A prosthetic valve can consist of artificial material (mechanical) or can be made from an animal heart valve, usually from a pig (bioprotestik). Determining the type of artificial valve depends on the age and whether you can use Coumadin blood thinners or not. Artificial heart valves increase the tendency for blood clots to occur. However, blood clots are less common in bioprotestic valves than mechanical valves, so patients using bioprotestic valves do not require Coumadin therapy.
Mechanical valves usually last longer than bioprotastic valves. If you need mitral valve replacement, aged under 65 years and can use Coumadin, your doctor will recommend this option for you. If you are 65 years or older, or cannot use Coumadin, a bioprotastic valve will be recommended.
Decision for mitral stenosis surgery
If you have mitral stenosis, you need to discuss it with your cardiologist to determine if surgery is needed and when, then you can choose the operating method that best suits your needs. With initial diagnosis and maximum care, generally individuals with mitral stenosis can live normally.
Hello Health Group does not provide medical advice, diagnosis or treatment.
