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.

Transcript

00:00

In an older population, calcified valves, poorly functioning hearts, complicated other problems, replacement is very often a better choice.

00:08

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00:15

Mitral valve repair and replacement are controversial as to the virtues of one

00:21

versus the other, but each has a role. Mitral valve replacement involves what it says.

00:27

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

00:37

and achieve normal function at the end of it. The goal of both replacement and repair is a well functioning mitral valve, obviously.

00:44

But in one sense, repair preserves more of the patient's tissue, which arguably has virtues. In the other sense, replacement eliminates

00:53

some of the technical finesse of repair and guarantees a good, quick outcome with a functioning valve.

00:59

There is a long discussion of the pros and cons. It's highly related to the problem

01:05

a patient presents with. So a little difficult to quickly generalize. In one extreme, patients with degenerative mitral valve

01:13

disease that is typically in younger people that's non-calcified, the primary goal would always

01:19

be repair, although not achievable 100% of the time. In an older population, calcified valves,

01:26

poorly functioning hearts, complicated other problems, replacement is very often a better choice.