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Mitral valve replacement

Mitral valve replacement
Intervention
ICD-9-CM 35.23-35.24
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Mitral valve replacement is a cardiac surgical procedure in which a patient’s diseased mitral valve is replaced by either a mechanical or bioprosthetic valve. Mitral valve replacement is performed when the valve becomes too tight (mitral valve stenosis) for blood to flow into the left ventricle, or too loose (mitral valve regurgitation) in which case blood can leak back into the left atrium and thereby back into the lung. Mitral valve disease can occur from infection, calcification, inherited collagen disease, or other causes. Since a mitral valve replacement is an open heart surgical procedure, it requires placing the patient on cardiopulmonary bypass.

Many mitral valves can be repaired instead of replaced, especially for minimally damaged valves. Advantages to valve repair instead of replacement include lower surgical mortality (1-2% for repair versus 6-8% for replacement), lower risk of stroke, lower rate of endocardial infection, and improved long-term survival. Patients who receive a valve repair stay on the same survival curve as the normal population. After mitral valve repair, blood thinners are not required; however, lifelong maintenance on blood thinners is required after mechanical mitral valve replacement. Mitral valve surgery can now also be performed robotically although the procedure may take longer.

Most patients can endure surgery without complications; however, there are some whose heart functions are too weak to withstand surgery. Non-surgical approaches to treat heart valve disease without surgery are divided into three categories: Clinical Practice treatment (this is used in every day clinical practice), Investigational treatment (current clinical studies that are underway), Early Development treatment (early stages of investigation).


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