If medicines are not effective in
controlling your symptoms of
mitral valve stenosis or if your doctor determines
that you need more aggressive treatment, you may need surgery to repair or
replace your mitral valve. Valve surgery is common and usually
successful. But a degree of risk is associated with this invasive procedure. There
are generally three options: a balloon valvotomy, a closed (or open)
commissurotomy surgery, or valve replacement surgery.
Valve repair (balloon valvotomy)
Balloon valvotomy (percutaneous mitral balloon valvotomy) is the method of
choice for treating mitral valve stenosis in select patients. A thin flexible
tube (catheter) is inserted through an artery in the groin or arm and threaded
into the heart. When the tube reaches the narrowed mitral valve, a balloon
located on the tip of the catheter is quickly inflated. The balloon, pressing
against the narrowed mitral valve leaflets, separates and stretches the valve
opening and allows more blood to flow through the heart. This procedure does
not require open-heart surgery, so recovery is easier.
valvotomy is usually recommended if you have symptoms, moderate to severe
stenosis, and most of your mitral valve is a normal shape.
A balloon valvotomy may also be used to treat people with mitral valve
stenosis who do not yet have symptoms (asymptomatic) if they have:1
Your doctor may recommend a balloon valvotomy if you are
planning to have another surgery (not on your heart), if you are pregnant, or
if you are planning a pregnancy.
People with signs of blood clots
in the left atrium, widespread calcification of the mitral valve structures, or
moderate to severe
mitral valve regurgitation are not considered good
candidates for a balloon valvotomy.
mitral valve may narrow again (restenosis) after 10 to 20
Depending on the amount of damage to
your mitral valve, your doctor may recommend surgery to repair or replace your
mitral valve. If the valve is damaged beyond repair, it will need to be
replaced. Mitral valve surgery may be done as an open-heart surgery, or a
minimally invasive surgery.
During open-heart surgery, your
heartbeat is stopped, and you are placed on a heart-lung machine to deliver
blood to your body. The heart-lung machine temporarily serves in place of your
heart and lungs by mixing oxygen with the blood, removing carbon dioxide from
the blood, and pumping the blood throughout your body.
minimally invasive surgery, your doctor makes a smaller incision than the
incision made in open-heart surgery. You may still be placed on a heart-lung
machine. Valve repair or replacement is similar for minimally invasive surgery
and open-heart surgery.