Mitral Valve Repair and Mitral Valve Replacement

Why Should I Choose Minimally Invasive Mitral Valve Repair or Mitral Valve Replacement?

Many individuals who need mitral valve repair surgery or mitral valve replacement prefer to avoid having their breastbone opened for understandable reasons. The cut is large, and somewhat painful. In addition, healing takes nearly 3 months, and this prevents rapid return to normal activities.

Few people are aware that both mitral valve repair surgery and mitral valve replacement can be performed both safely, and effectively without resorting to cutting the breastbone. Mr Birdi and the Keyhole Heart Clinic team have been performing keyhole mitral valve surgery for more than 17 years.

Inder Birdi says:

“We will always aim to perform repair of the mitral valve whenever possible to maximise the long-term benefits of the procedure, preserve heart function and avoid anticoagulation requirements. If patients are suitable for the keyhole heart surgery, then this will always be our strong recommendation through our service.”

Mitral Regurgitation: How Do We Assess Whether You Are Suitable for Keyhole Mitral Valve Repair Surgery?

To assess your suitability for keyhole heart surgery we will gather data from your echocardiogram, ECG, and coronary angiogram. Many patients who come to us have already undergone these tests and usually, we simply need to obtain the images for review. You will also need a CT scan to look at the health of your main blood carrying pipe called the aorta to assess your suitability to receive micro-pipes in the groin to establish you on the heart lung machine. This test only takes a few minutes and provides so much added information about your general health as well.

Once we have decided that you are suitable for keyhole mitral valve surgery, we will plan the surgery to occur as soon as possible and certainly within two weeks of your assessment.

How Is Keyhole Mitral Valve Repair Surgery Performed?

Keyhole Mitral valve repair or replacement is performed through a small incision over the right side of the chest between the ribs and does not require the need to cut any bone. The wound heals within 7 to 10 days and is cosmetically very appealing. This is the preferred technique for mitral valve repair keyhole surgery at The Keyhole Heart Clinic and our preferred location is at The London Clinic venue.

We do not use the Da Vinci Robot since we have become highly skilled in the use of specialised designed surgical instruments to perform the surgery with extreme accuracy. Using these instruments, and a 4K television monitor, we can achieve perfect results very quickly with the resulting time on the heart lung machine being significantly shorter than with robotic surgery. We believe that this leads to a far superior recovery because of the reduction in heart lung bypass related dysfunction.

We also avoid spreading the ribs apart which means that the pain associated with surgery is minimal. Patients who undergo keyhole mitral valve surgery experience:

• Less Pain
• Less Risk Of Wound Infection
• Healing In Days Rather Than Months
• Smaller Scars
• Quicker Recover

If you have mitral valve leak, the mitral valve repair is usually performed by using a technique where any torn mitral valve strings are replaced using a Gortex string or chord. Occasionally we perform a triangular resection mitral valve repair of the abnormal part of the leaflet to fix the leak. After the leaflet is repaired, a ring is stitched into the heart to stabilise the shape of the mitral valve “doorway”. When the mitral valve is calcified, it is better to replace the mitral valve with a tissue valve (pig or cow) or metal valve.

Is Keyhole Mitral Valve Surgery Risky?

Mitral valve surgery is both very safe and very effective. If performed by keyhole heart surgery, the risks are even lower with less bleeding, less infection, less pain, and swifter recovery. The only caveat to this is that keyhole heart surgery must always be performed by experienced teams, and we always recommend that you ask your surgeon how many cases he/she has performed.

Breastbone Incision Versus Keyhole Heart Surgery

Will Mitral Valve Surgery Improve My Symptoms?

Early mitral valve surgery will not only improve symptoms of breathlessness and tiredness, but it will also make you live longer. Therefore, it is so important to be assessed by experts in heart valve disease diagnosis and management.

How Long Is The Recovery From Mitral Valve Repair or Replacement?

Most patients will spend 4-7 days in hospital and by the time you have been discharged, you will be walking unaided. Following keyhole mitral valve surgery, you will feel tired for a week or two. You will be able to perform most daily tasks and by the third week after your surgery you should be walking at least one mile per day unless you have another medical problem that prevents this. By week 4 you can return to light exercises which you can build up over time. Once your surgeon reviews you in clinic, you will be able to reduce some of the medications that you were given from the hospital.

If you underwent surgery through the breastbone, your recovery will be slower, and you must avoid activities that could disrupt the stability of the breastbone for at least 12 weeks.

Can I Delay My Mitral Valve Repair Surgery?

Once you have developed severe mitral valve leak, or indeed if the mitral valve is not opening well because it is calcified and stenosed, there are certain risks that must be avoided to ensure that you will live a long and healthy life after the procedure.

One of the most important, and avoidable complications of mitral valve disease is an irregular heartbeat called atrial fibrillation. Once this develops, it reduces heart function by up to 30%, and creates clot related stroke risk. This latter issue means that you will be forced to take a blood thinner like warfarin (or drugs called NOAC’s) for the rest of your life. The other serious complication associated with mitral valve disease is high blood pressure in the lungs (commonly referred to as pulmonary hypertension). These two complications can be avoided by early surgical intervention.

Inder Birdi says:

“Patients with mitral valve disease are often referred for surgical intervention too late in their disease pathway for them to receive the greatest benefit that surgery offers. I would like to see patient before they develop atrial fibrillation or high lung blood pressure, even if they have no symptoms”

What Is The Cost Of Mitral Valve Repair In The UK?

The cost of private mitral valve repair or replacement in the UK is about £35,000. This includes a 7 day stay in hospital, your surgeon’s and anaesthetist’s fees and the technology used to perform your surgery. The benefit of private treatment relates to both the speed with which you can have your surgery, as well as the advantage of allowing you to choose your surgical team. Learn more about our service here.

Can I Come to The Keyhole Heart Clinic if I have Mitral Valve Regurgitation?

Yes. If you wish to see us, you can arrange an online appointment or a face-to-face consultation with Mr Birdi and his team. We will obtain your current test results and perform only those tests that we require if they have not been performed. The key tests include ECG, Echocardiogram, Coronary Angiogram and CT scan. We can then counsel you on your suitability for keyhole mitral valve repair or keyhole mitral valve replacement based.

To arrange an appointment, you can use one of the links on this page or call us on +44(0)20 4527 3456.