What are the symptoms of Mitral Valve Insufficiency?

What is mitral stenosis? Mitral valve surgery It is done by repairing or replacing the mitral valve itself or the ring. Thanks to the experience in heart valve surgeries for many years, artificial valves have been developed and have also contributed to the development of surgical techniques. The most preferred metallic heart valves today are bi-leaflet carbometal structures and although they require anticoagulants, they are long-lasting. In addition, biological valves made of bovine or porcine pericardium have been developed for those who cannot use anticoagulants, especially the elderly or those considering pregnancy. Mitral valve replacement or repair had been performed with sternotomy for many years. Due to the complications of sternotomy, mitral valve surgeries began to be performed with anterolateral thoracotomy in the world in the 1990s and the entry incisions were gradually reduced. In 1997, we first started performing our surgeries in our country by converting them to subaxillary incisions and contributed to the national and international literature in series. Although there is no difference in the surgical technique, the entry technique has been proven to be advantageous from bleeding to infection and early return to daily life. It reduces complications especially in patients with diabetes, rib cage disorders, kidney failure, obesity, etc. In addition, the small size of the incision and its location on the side are also important from a cosmetic perspective.
On the other hand, the entry point of the surgery provides excellent visibility and access, especially in terms of mitral valve exposure. This is another factor that reduces complications. If both mitral and aortic valve replacement is required due to the different entry elevations, Aortic and mitral valve (double valve) surgery should not be performed with this technique. In such cases, the anterior incision, ministernotomy, is more useful and does not cause any entry site complications.

Technical : The patient is placed on the left side of the chest under double lumen intubation and general anesthesia; that is, the anterolateral thoracotomy position is given with the chest right side up. A vertical 6 cm incision is made over the intersection of the subaxillary line and the right breast line, and the pectoralis major and pectoralis minor are incised. without cutting the muscles dissected and retractor placed, thorax is entered through 4th intercostal space and right lung ventilation is closed or if not tolerated tidal volume is decreased. Pericardium is opened and its leaves are hung on the chest wall. Aorta, right and left atrium are clearly seen. After turning the aorta with pedicle, it is suspended and aorta and right auricle, right atrium are easily cannulated. Patient is connected to heart lung pump, extra-corporeally transferred, ventilation is stopped and x-clamp is placed on aorta. Cardiac arrest is provided by applying cold blood cardioplegia and topical cold serum physiological. Left atrium is opened and mitral valve image is clear. Left atrium is closed after repair or replacement. Patient is warmed, heart is defibrillated if necessary, after working, pump is stopped by decreasing flow. The heart is easily decannulated. After bleeding control, a single chest drain is placed in the thorax (drain placement is important to avoid pain), the ribs are approximated, and the muscles and subcutaneous tissue are closed according to the procedure. Postoperative follow-up is the same.
While this intervention technique can be applied to any patient, it is only In some cases it should not be preferred. These :

In addition, the mitral valve will be operated for the second and third time.

It is an ideal method for surgeries.

How is Mitral Valve Insufficiency Treated?

Early diagnosis and treatment are of great importance in the treatment of heart valve diseases. If the insufficiency or stenosis problem in the heart valves progresses too much, treatment may become difficult. Today, using minimally invasive surgery, heart valve repair or replacement can be performed from the side chest wall, lower end of the chest or under the armpit. Mitral valve surgery performed using closed heart surgery methods allows patients to return to their daily lives in a shorter time. However, the risk of bleeding after closed heart surgery is lower and patients do not experience pain complaints as in open surgery.

What Happens If Mitral Valve Diseases Are Untreated?

If mitral valve insufficiency or stenosis problems are not treated, blood pools in the lungs and lung blood pressure rises. This condition, which causes heart failure, can be life-threatening. Performed with minimally invasive surgery mitral valve surgery While it has a high success rate, it also provides advantages in terms of patient comfort.