Surgery for Valvular Heart Disease
Mitral Valve Repair and Replacement
The Mitral Valve, also known as the Bicuspid Valve with two valve leaflets, lies between the Left Atrium and the Left Ventricle serving as a doorway opening into the Left Ventricle allowing the blood to move in one direction from the Left Atrium to the Left Ventricle.
Since it is subject to the highest pressure difference, it is the valve that is most commonly diseased. Common causes of mitral valve disease are:
These diseases cause the opening of the valve to either become narrowed (mitral stenosis) or become incompetent allowing the blood to leak back into the Left Atrium (mitral regurgitation).
Mitral valve repair is a surgical procedure where the diseased mitral valve is debrided of all diseased tissue and restored to its previous, natural and functional state. It allows the surgeon to preserve the original valve of the patient.
Whereas, mitral valve replacement is a surgical procedure where the diseased mitral valve is completely excised and replaced with artificial, man-made heart valve prosthesis. This prosthesis can be of biologic or metallic origins.
Aortic Valve Repair and Replacement
The Aortic Valve, usually a tricuspid valve, is the doorway between the Left Ventricle and the Aorta. It regulates the flow of blood out from the heart to other parts of the body.
Aortic valve disease also occurs due to the same five reasons as stated in the mitral valve section. Although initially, only aortic valve replacement was available as a therapeutic surgical option, now we are able to offer our patients the option of an aortic valve repair. The aortic valve repair is performed using the same principles of the mitral valve repair and is very durable when performed by an experienced surgeon.
In some situation,if clinically indicated,the aortic valve can be replaced percutaneously or by using a minimally massive approch, even without using the cardiopulmonary bypass machine.
Tricuspid Valve Repair and Replacement
The tricuspid valve is a three leaflet valve allowing the flow of blood from the Right Atrium to the Right Ventricle. Tricuspid valve disease occurs due to the same five reasons as detailed in the Mitral Valve section. However, the tricuspid valve can also be affected by “back pressure effects” caused by diseases of the Left side of the heart and its valves.
It is imperative to repair or replace the tricuspid valve if affected during surgery for the left sided valves as long term mortality and morbidity is much less when it is done. In experienced hands, it is almost always possible to repair the tricuspid valve.
The tricuspid valve opening can become narrowed as in “Tricuspid Stenosis” or the valve can become incompetent causing “Tricuspid Regurgitation”.
Pulmonary Valve Repair and Replacement
The Pulmonary Valve, a tricuspid valve, is the gateway between the Right Ventricle and the Main Pulmonary Artery allowing blood to flow from the Right Ventricle to the Lungs for oxygenation. It is usually diseased due to congenital reasons and its lesions are usually associated with congenital heart disease.
