Normal heart valves are thin and smooth and their role is to direct blood to the cavities of the heart. Over time, however, they can become stiff, and difficult to open, so we have a valve stenosis or they fail to close completely, so we are talking about valve insufficiency.
Other causes of valve disease:
- Congenital anomalies
- Rheumatic fever
Affected valves complicate the work of the heart and can cause arrhythmias or even clots in the heart.
Mitral valve prolapse (myxomatous degeneration or Barlow's syndrome) is the most common cause of mitral regurgitation, occurring in 2.5% to 5% of the general population.
Mitral regurgitation is primarily a disease of the leaflets that thicken and gain excess tissue. The increase in the surface of the leaflets causes a fall in the left atrium during contraction. The leaflets' cords lengthen and thin due to the pathologically high forces exerted on them due to the increase in the size of the leaflets. Thus they become prone to rupture.
The mitral ring is also affected, as are the papillary muscles.
Histologically, there is damage to the connective tissue of the leaflets
Patients with severe mitral regurgitation due to prolapse are treated surgically with endoscopic repair of the mitral valve.
The same is true for patients with severe mitral regurgitation and left ventricular dysfunction. Also, patients with recent onset of atrial fibrillation with a background of chronic mitral regurgitation have indication for surgery. The chances of defibrillation and recovery of the sinus rhythm are high if atrial fibrillation is established for less than six months.
Approximately all cases of mitral regurgitation due to:
- Flail Mitral Valve/ Mitral Valve Prolapse (myxomatous degeneration)
- Ischemic cardiomyopathy
- Idiopathic dilated cardiomyopathy
- Valvular dilated cardiomyopathy
are treated by our heart surgery team with endoscopic valve repair.
All heart valve replacement or repair procedures are performed endoscopically, unless a coronary artery bypass surgery is required at the same time.
Only in cases of heavily calcified valves we replace the valves with prosthetic ones.