Surgery helps swinging door heart valves

Mitral valve surgery can best be described by comparison to the swinging saloon door in old western movies. It demonstrates what can go wrong with the heart’s valves — and what surgical procedure is needed to correct mitral valve prolapse (MVP).

The mitral valve separates the two left chambers of the heart. Each time the heart beats, the valves swing open. But after opening, they close firmly again while the heart pumps blood to the body.

The problem is that swinging doors of saloons often develop loose rusty hinges that don’t close well. The mitral valve has the same trouble when the tough parachute-like cords that attach the valves to the heart’s muscle become too loose. When this happens, some ejected blood falls back into the heart’s chamber following every beat. This places extra burden on the heart’s muscle.

According to a report from Johns Hopkins University, about 25 per cent of Americans older than age 55 have some degree of MVP. It’s now believed that, in addition to aging, genetics also plays a role.

Some patients complain of shortness of breath, palpitations and fatigue. But people without MVP can experience similar symptoms.

Dr. Tirone David, one of the world’s great cardiac surgeons, said several factors must be considered before deciding mitral surgery is needed. One of the most important is the severity of the prolapse and what affect it’s having on the heart’s muscle.

In mild cases of MVP, there’s no point in exposing patients prematurely to the risk of surgery. But it also makes no sense to wait until either the patient’s symptoms are severe or the muscles of the heart are failing from extra stress.

Surgery is also performed when the mitral valve becomes thickened and rigid from aging and the opening becomes as small as a pencil. The extra work of pushing blood through such a tiny opening can also cause heart failure.

Patients with these conditions often have heart murmurs that can be detected by a stethoscope. But an echocardiogram of the heart will determine their severity and help to gauge whether the condition is worsening.

In recent years, there’s been tremendous advancements in surgical technique for the treatment of MVP or stenosis.

The majority of cases performed today try to save the old valve. For instance, it is often possible to shorten the parachute-like cords which restore the valves to their normal position. The advantage to using the patient’s own tissue is that there is no chance of its rejection by the body.

In other cases, minimal invasive surgery can be done by working through the femoral artery, the blood vessel at the top of the leg. A new valve is guided through the artery until it reaches the mitral valve location and is inserted. See the website: www.docgiff. com For comments: info@

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