Choosing a mitral valve repair surgery

If you decide on surgery to repair your mitral valve stenosis, you and your doctor will need to select either a balloon valvotomy or a mitral commissurotomy. In spite of similar success rates, a balloon valvotomy is generally preferred to mitral commissurotomy as long as the doctor is experienced with the procedure.

Balloon valvotomy is catheter-based, not surgical, and has a lower risk of complications and death than mitral commissurotomy. But a balloon valvotomy done by an inexperienced cardiologist has approximately the same percentage of negative outcomes as that seen with a commissurotomy. So it is important that you have your balloon valvotomy done at a medical center that routinely does a large number of these procedures.

Both procedures have risks, but the risks are rare. Most commonly, "cracking open" valve leaflets will cause the valve to begin to leak, causing mitral regurgitation. There is also a slight chance that a blood clot will develop in your heart and cause a stroke. But the most common problem with both procedures is that they typically need to be repeated after 10 or 20 years because the valve becomes narrowed again. At this point, you may need a valve replacement due to damage done to the leaflets during the earlier operations.

Last Updated: February 10, 2010

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