Re: mitral valve repair

Posted By CCF CARDIO MD - MTR on March 01, 1999 at 10:35:32:

In Reply to: mitral valve repair posted by Marguerite on February 26, 1999 at 12:52:56:






My husband had a TEE this week which showed that his posterior leaflet was torn on his mitral valve. But according to the cardiologist, it looked repairable. What is involved with repair. Is it still considered open heart surgery. Do you have to put the patient on a heart lung machine to stop the heart while sewing up the valve. Besides asking a surgeon what is rate of successful repair is, how can we determine a good surgeon for this type of repair. Is this particularly tricky or fairly easy, as valve repairs go. Would there by any good reason for waiting to have this done since it has to be done eventually. Both his atrium and ventricle are enlarged but his heart muscle is 100%. What is the typical recovery time. Off work. Bedrest. Limited activity etc. What is that special procedure I saw someone referring to Dr. Cosgrove about in another forum message? Does anyone in Virginia, Maryland or DC do it? Lastly, he is on Zestril. He seems to have gas and heartburn now. Is this a side effect of Zestril?





Dear Marguerite, thank you for your question.  In most cases, a torn posterior mitral valve leaflet can be successfully repaired to obviate the need for replacement of the mitral valve with a prosthesis that would require lifelong blood thinners.  During a mitral valve repair, the heart has to be stopped and placed on a heart-lung bypass machine because the cardiac chambers are directly opened to access the disease valve.  
A minimally invasive approach could be used which would mean a smaller surgical scar, but this is still considered open heart surgery.  Since your husband's heart chambers are beginning to enlarge, now is the time for him to have mitral valve repair.  Dr. Cosgrove at Cleveland Clinic is the foremost pioneer in mitral valve surgery and he would be an excellent choice for this procedure.  If you would like your husband to be evaluated for surgery by Dr. Cosgrove, then call Cathy who works in his office at 1-800-CCF-CARE pager 24774.  I don't know of any specific surgeons in the DC area who specialize in mitral valve repair, but I suggest that you look into Fairfax Hospital, Georgetown, Washington Hospital Center, Johns Hopkins, University of Virginia, or Medical College of Virginia.  The typical recovery time after open heart surgery is 6 weeks and the time off from work is 4 - 6 weeks on average.  We typically encourage patients to be out of bed by post-op day 2 and to restrict activities for 4 - 6 weeks after surgery.  Gas and heartburn are not known side effects of Zestril.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional 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.