Mitral Valve Repair/Replacement

  What are the factors to consider in deciding when to repair or replace
  a Mitral Valve?
  Can a Mitral Valve Prolapse contribute or cause Atrial Fibrillation?
  If it does, what is the probability of eliminating Atrial Fibrillation by
  replacing or repairing a Mitral Valve?

[CCF CARDIO MD APS]

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Dear Bryan,
The mitral valve (MV) is one of the most repairable valves, but how repairable
it is, well this is dependent on a number of factors including the experience of
the cardiothoracic team. Of course our own Chairman of Cardiothoracic Surgery, Dr. Cosgrove, is a pioneer of valve repair.
It is the feeling at the Cleveland Clinic that EVERY attempt possible should
be made to repair a valve and replace only if absolutely necessary.  This is especially
so in young persons, for so many reasons that I can not even begin except to say
that if It can be fixed, why replace it with something artificial that will require
medications and reoperations, and so on.
If the MV is floppy as it often is in MVProlapse, it is often just a matter of resecting the extra
tissue to repair.  The final decision is always, should always be, that we will try to repair and replace only if neccesary.
MVP that causes a leak (mitral regurgitation) is often the cause or instigator of the atrial fibrillation,
and when that develops, even before, it is time to repair/replace the valve.
Yes, some patients no longer have a.fib following MV repair since it relieves the leaky valve which relieves the back pressure
on the atria (upper chamber of the heart) which then reduces the instigation for a.fib.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.