Mitral valve stenosis: Repair or replace the valve?

If you have mitral valve stenosis and have decided you need surgery for your mitral valve, you have a choice of repairing it or replacing it. When making this decision, you and your doctor need to consider:

  • The condition of the valve and what is causing the stenosis. The more severe the stenosis, the more likely replacement will be necessary.
  • The surgeon's skill and experience in performing the procedures. Both valve replacements and balloon valvotomies are highly technical and should be performed by an experienced surgeon.
  • Whether you have a blood clot in your left atrium.
  • How urgently you need treatment.
  • Whether your heart rhythm is regular or irregular.

Both balloon valvotomy and mitral commissurotomy repair your mitral valve, while a valve replacement removes it and replaces it with an artificial valve.

Generally, mitral valve repair is preferred if your:

  • Valve is suitable for it.
  • Surgeon has the appropriate level of experience and surgical skill.

The advantages of mitral valve repair are that it:

  • Preserves your natural valve.
  • Leads to fewer complications and better postoperative results (generally lower risk of mortality) than mitral valve replacement.

The disadvantages of mitral valve repair are that:

  • Not all valve problems can be repaired.
  • The repair may not last and then you may need valve replacement surgery.

Last Updated: February 10, 2010

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