Mitral Valve Repair

In Maryland, University of Maryland Physicians Care for the Most Heart Surgery Patients - University of Maryland Medical Center

Of all the heart valves, the mitral valve is the most commonly repaired. An operation on the mitral valve is usually needed because it is leaking (regurgitation), does not fully open (stenosis), there is prolapse that cannot be treated with medicine, or there is an infection (endocarditis).

Research shows that mitral valve repair is preferable to replacement for patients with a leaking valve and many with narrowed valves. If mitral valve cannot be repaired, replacement may be an option. However, our team is dedicated to finding a way to salvage your valve, restore its function and protect your heart. Meet our team.

Mitral Valve Repair at the University of Maryland Heart and Vascular Center

When performed correctly, patients who have undergone mitral valve repair see significant improvement. It is the only heart operation in which your life expectancy afterward is identical to someone with no heart disease.

Receiving care at a top valve program with skilled and experienced physicians directly impacts your likelihood of keeping your own valve and achieving a successful outcome. At the University of Maryland’s Heart Valve Program, you can expect:

  • Proven Results: Our repair rates for degenerative mitral valve disease are in excess of 95 percent, while the national average is 60 percent to 70 percent. Learn more about valve regurgitation and valve stenosis.
  • Experience: Our lead mitral valve surgeon, James Gammie, MD, performs hundreds of repairs a year. Overall, our mitral valve team performs two and a half times as many repairs as any other program in Maryland. More experience means better outcomes for our patients.
  • Teamwork: Heart center specialists covering all aspects of mitral valve care meet weekly to discuss who may benefit from surgery and who will likely not. This helps us make the best recommendation. 
  • Treatment choices: We offer minimally invasive surgical repair that leave behind smaller incisions, with our lead surgeon, Dr. Gammie, completing more than 350 of these in his career. For patients who cannot undergo traditional surgery, we offer catheter-based repairs. (Learn more about transcatheter mitral valve repair.) When repairs are not possible, we can replace the valve with the latest artificial valve. 

How Mitral Valve Surgery Works

In the past, surgeons simply replaced problematic mitral valves. While many centers still do this for a significant portion of cases, we have taken a different approach that allows the bulk of our patients to keep their valves.

Some examples of our surgical repair include:

  • Sewing in a new ring of plastic, cloth or tissue to support the valve’s circular frame (the annulus)
  • Trimming off the diseased portion of a valve flap (leaflet) and closing up the defect
  • Reconstructing leaflets, then using sutures to support the valve
  • Replacing a leaflet using tissue surrounding the heart (the pericardium)

Benefits of Heart Valve Repair

When performed by top surgeons like ours, mitral valve repair is very successful. Approximately 90 percent of repaired valves are still working 20 years later, with just 10 percent of patients needing a second operation during that time.

Mitral valve repair also offers a number of clear benefits over replacement:

  • Higher survival rates
  • No long-term use of blood thinners (required if you get a mechanical replacement valve)
  • Safer — lower risk of mortality, infection and stroke

Complex Mitral Valve Repairs

Our mitral valve expertise extends to repairs of complex cases. These can include:

  • Patients who previously underwent surgery for another heart-related problem like a blocked artery and subsequently need a mitral valve repair
  • A repaired valve developing a new leak due to a cause like infection
  • Valves that were not properly repaired at another center

These cases require skilled surgeons because the valve is often surrounded by scar tissue that naturally develops as the body heals from previous operations. Follow-up operations are also challenging when patients are elderly, in poor health for other reasons or have poor heart function.

Minimally Invasive Mitral Repair

We lead the way in minimally invasive mitral valve repair. We performed Maryland’s first catheter-based repair, and we also completed the mid-Atlantic’s first surgical repair using a minimally invasive approach.

We offer two types of minimally invasive mitral valve repair, for separate reasons:

  • Patients who cannot undergo an operation: We offer catheter-based repair for patients with leaky valves (regurgitation), as an approved treatment or through a clinical trial. That means we do not have to open the chest or use a heart-lung machine. (Learn more about transcatheter mitral valve repair.) We can also open some narrowed mitral valves with a catheter and a balloon. (Learn more about valvuloplasty.) 
  • Patients who prefer a smaller incision: Some of our patients who are eligible for surgery prefer smaller incisions, made on the side of the chest. While the standard approach is very successful, we try to honor this request when possible. But sometimes we cannot, since we need to prioritize your health and valve function. This type of minimally invasive surgery still requires a heart-lung machine, which temporarily takes over for the heart and lungs. 

For more information or to make an appointment, please call 1-866-408-6885.

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