How does mitral valve repair compare with mitral valve replacement?
To repair or replace? Often, that is the question with a damaged mitral valve. In this video, cardiothoracic surgeon Craig Smith discusses the best candidates for each procedure.
In an older population, calcified valves, poorly functioning hearts, complicated other problems, replacement is very often a better choice.
Mitral valve repair and replacement are controversial as to the virtues of one
versus the other, but each has a role. Mitral valve replacement involves what it says.
It replaces the mitral valve. Mitral valve repair uses a variety of technical strategies to preserve all or most of the patient's native mitral valve
and achieve normal function at the end of it. The goal of both replacement and repair is a well functioning mitral valve, obviously.
But in one sense, repair preserves more of the patient's tissue, which arguably has virtues. In the other sense, replacement eliminates
some of the technical finesse of repair and guarantees a good, quick outcome with a functioning valve.
There is a long discussion of the pros and cons. It's highly related to the problem
a patient presents with. So a little difficult to quickly generalize. In one extreme, patients with degenerative mitral valve
disease that is typically in younger people that's non-calcified, the primary goal would always
be repair, although not achievable 100% of the time. In an older population, calcified valves,
poorly functioning hearts, complicated other problems, replacement is very often a better choice.
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