Mitral valve repair offers a very normal life to the patient since it doesn’t require lifelong blood thinning medication and its results last much longer than animal valves. Mitral repair offers lower operative and long-term mortality than valve replacement, as well as better preservation of left ventricular function and reduced risk of infective endocarditis. Reoperation rates for both repair and replacement are similar, about 1-2% per year. Repair is usually the treatment of choice for patients with mitral valve prolapse who need treatment.
Unfortunately, only a fraction of surgeons nationwide have experience with mitral valve repair. NYP/Columbia surgeons have one of the largest experiences in mitral valve repair, and in fact most of our patients with mitral regurgitation are treated with valve repair rather than replacement.
Dr. Craig Smith – How does mitral valve repair compare with mitral valve replacement?
Minimally Invasive and Robotic Techniques
Surgical repair of the valve may be achieved by comissurotomy, a procedure in which small incisions are made to free the valve leaflets. NYP/Columbia surgeons routinely perform mitral valve repair and replacement minimally invasively. Our approach utilizes a 2-inch minithoracotomy incision and central aortic cannulation, avoiding the risks of peripheral (femoral) arterial access. All types of complex mitral repairs are possible through this approach, as well as common adjunctive procedures, such as the modified MAZE procedure for atrial fibrillation, ASD or PFO repair, or tricuspid valve procedures.
PERCUTANEOUS MITRAL VALVE REPAIR: MitraClip
Columbia surgeons and interventional cardiologists have pioneered the use of the MitraClip™, which allows mitral valve repair without surgery. In appropriate patients, our physicians guide a catheter, or thin tube, through the vascular system to the mitral valve, using x-ray and echocardiographic imaging to show the way. The MitraClip™, located on the tip of the catheter, is placed at the center of the valve leaflets to hold them together. Patients have a brief recovery time and are able to resume their normal activities within days of this procedure. This technology was actually developed at NewYork-Presbyterian/Columbia, and is based on a surgical procedure known as the “bow-tie repair.” Our physicians are currently participating in clinical trials testing this device in high-risk patients.