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Why is mitral valve repair so advantageous over replacement?


There are two types of surgical interventions for mitral regurgitation. These; valve replacement and repair methods. Valve replacement: The mitral valve is removed and replaced with a biological or mechanical valve. Since the lifespan of biological valves is limited to 10-15 years, it is generally preferred over the age of 65.



Mechanical valves are not life-limiting. In patients with this valve, life-long blood thinners and anticoagulants are required. In the use of this drug, continuous blood level monitoring should be performed. In insufficient use of the drug, clots are formed, and in excessive use, bleeding occurs. In the repair, the cover structure is corrected and the leakage is eliminated. Since the muscles holding the valve remain in place, heart functions are better preserved. There is no need for blood thinners used in patients whose valves are changed after repair.



In our country, 30-40% of patients with mitral regurgitation are not suitable for repair. Most of these patients are leaks due to rheumatic involvement. In these, valve repair is not successful due to thickening and calcification in the valves. However, the success rate of repairs in the remaining degenerative mitral regurgitation is quite high. Most of the degenerative mitral regurgitation is caused by sagging of the middle part of the mitral posterior leaflet. The success rate in surgical repairs performed for this purpose is close to 90-100%.



However, the success rate decreases in sagging that includes both anterior and posterior leaflets and where the mitral ring is very enlarged.



Valve repairs can also be beneficial in insufficiency due to narrowing or occlusions in the vessels that feed the muscle holding the valves, which is one of the important causes of mitral regurgitation.



Mitral valve repairs are performed with minimally invasive surgical technique with 3-5 cm small incisions under the right breast. Again, valve repair is performed through small incisions under the breast with the help of a robot.



Valve repairs require serious surgical dexterity and experience, and many surgeons solve the same valve problem with different surgical techniques. Despite the differences in surgical techniques, the results are similar. The important thing is that the repairable covers are repaired without replacing them.

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