Mitral Valve Repair

Mitral valve repair fixes your own mitral valve, which lies between the left upper and lower chambers of the heart, so that it closes properly again. It is mainly used for mitral regurgitation, a leaking valve, most often caused by a floppy or prolapsing leaflet or a torn supporting cord.

When the valve can be repaired, results are better than with replacement: lower operative risk, better preservation of heart function, and no need for lifelong blood thinners in most cases. Not every valve is repairable. Rheumatic, heavily calcified or infected valves often need replacement, and a small percentage of repairs leak again over the years.

What Mitral Valve Repair involves

Assessment centres on echocardiography, including a transoesophageal echo with 3D views that shows exactly which part of which leaflet leaks. Coronary angiography or CT is done before surgery in most adults. Under general anaesthetic, through a breastbone incision or a 5 to 7 cm cut between the ribs on the right, you are connected to a heart-lung machine and the heart is stilled. The surgeon opens the left atrium and tests the valve. Typical steps are removing or folding the excess leaflet segment, replacing broken cords with fine Gore-Tex sutures, and stitching an annuloplasty ring around the valve to restore its shape. The repair is checked by echo in theatre before the chest is closed. If the result is not good enough, the valve is replaced during the same operation.

Who is a good candidate for Mitral Valve Repair?

Timing matters. Guidelines advise surgery before the heart muscle weakens.

• Severe primary mitral regurgitation with breathlessness or reduced exercise capacity
• Severe leak without symptoms but with early signs of strain: falling ejection fraction, enlarging left ventricle, new atrial fibrillation or rising lung pressure
• Degenerative prolapse judged highly repairable on echo, in a centre with high repair rates
• Frail or high-risk patients with suitable anatomy, for a clip procedure instead of open surgery

Es ist normalerweise nicht die richtige Wahl, wenn:

• Mild or moderate regurgitation, which is monitored rather than operated on
• Rheumatic mitral stenosis, treated by balloon valvuloplasty or replacement
• Heavily calcified or destroyed valves where replacement is more durable
• Leak that is secondary to a weak, enlarged heart, where medication and device therapy come first and surgery helps only selected patients

Technikoptionen

• Conventional repair through sternotomy: Full access; chosen when bypass grafts or other valves need attention at the same time.
• Minimally invasive repair through a right mini-thoracotomy: Smaller scar and faster return to activity for suitable anatomy; often video or robot assisted.
• Transcatheter edge-to-edge repair (MitraClip, PASCAL): A clip passed through the leg vein joins the leaflets. For patients at high surgical risk, without opening the chest.
• Mitral valve replacement: Mechanical valves last but need warfarin for life; tissue valves avoid long-term warfarin but wear out in 10 to 20 years.
• Concomitant AF ablation and left atrial appendage closure: Added when atrial fibrillation is present, to lower stroke risk.

Was passiert während Ihrer Behandlung

Surgery takes 3 to 5 hours under general anaesthetic. You spend 1 to 2 days in intensive care and 5 to 8 days in hospital in total. A clip procedure takes 1 to 3 hours, usually under general anaesthetic, with 1 to 3 nights in hospital.

Vorbereitung auf Ihre Reise

Plan for 3 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stoppen Sie das Rauchen und Nikotin mindestens vier Wochen vor und nach der Operation; es ist die größte vermeidbare Ursache von Wundproblemen
• Erzählen Sie dem Team von allen Medikamenten und Ergänzungen, die Sie einnehmen; Blutverdünner, einige Kräuterprodukte und Hormonbehandlungen müssen möglicherweise auf Anraten Ihres Arztes unterbrochen werden
• Vereinbaren Sie, dass jemand mit Ihnen reist oder erreichbar ist, und halten Sie die ersten Tage zu Hause frei von Arbeit und Heben
• Buchen Sie einen veränderlichen Rückflug; Ihr Chirurg bestätigt, wenn Sie fit sind

Genesung und Ergebnisse

After open repair, the breastbone takes 6 to 8 weeks to heal, during which you should not lift more than a few kilos or drive. Recovery after a mini-thoracotomy is often quicker, around 3 to 4 weeks. Blood thinners are commonly given for 3 months, longer if you have atrial fibrillation. Plan to stay about 2 weeks after discharge before flying, with your surgeon's agreement. Cardiac rehabilitation and an echo at 3 months, then yearly, are part of aftercare. You will need antibiotic cover for some dental procedures.

• Back to everyday activity: 4 to 8 weeks
• When results show: Breathlessness improves over weeks
• How long they last: Most repairs last 15 to 20 years or more

Sicherheit, Risiken und Revisionspolitik

In experienced centres the risk of death from isolated elective repair is around 1 percent, but it rises with age, weak heart function and other illnesses.

• Stroke, in about 1 to 2 percent
• Bleeding requiring transfusion or re-operation
• Atrial fibrillation after surgery, common and usually temporary
• Heart block needing a permanent pacemaker
• Wound or chest infection, kidney injury
• Residual or recurrent leak, with around 5 to 10 percent needing re-operation within 10 to 20 years
• Conversion to valve replacement during the operation
• Rarely, obstruction of blood flow by the repaired leaflet (SAM)

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Mitral Valve Repair in Türkiye

Clinic-Y does not publish a single price for Mitral Valve Repair, because the honest figure depends on your case. What moves it:

• Open, minimally invasive, robotic or transcatheter approach
• The clip device or prosthetic ring and any valve used
• Additional procedures such as bypass grafts or AF ablation
• Intensivpflege und Stationstage
• Pre-operative angiography and transoesophageal echo

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