Advantages:

1. Preservation of cardiac function.

2. Improved long-term results.

3. No need for anti-coagulation therapy.

4. Reduced mortality.

What are complex mitral valve repairs?

The treatment of mitral valve disease (rheumatic, myxomatotic or ischemic) involved, until fairly recently, replacement of the diseased valve with a mechanical prosthesis that required life-time treatment with anti-coagulants, or with a biological prosthesis that requires short-term anti-coagulation therapy only; however, the life-span of a biological valve is limited to 10-15 years.

Over the past few years, in the Tel Aviv Medical Center, complex mitral valve repairs are performed in cases where, in the recent past, the valve was replaced with either a mechanical or a biological prosthesis.  The complex repairs enable achievement of a better long-term surgical result, and avoid the use of anti-coagulants (which are required in the case of a mechanical prosthesis) and the risks of complications related to prosthetic (artificial) valves.

Many series demonstrate that mitral valve repair surgery has reduced intra-operative mortality compared with valve replacement, and better cardiac function.  In addition, long-term follow-up shows longer life expectancy in patients who underwent valve repair.

It should be pointed out that these good results are conditional with experience in valve repairs and, indeed, we believe that we have such experience here in the Dept. of Cardiothoracic Surgery at the Tel Aviv Sourasky Medical Center.

Video clips demonstration of complex mitral valve repair:

1. Folding repair - 36 sec.

2. Posterior leaflet repair -39 sec.

3. Sliding repair -2:19 min.

4. Examination of mitral valve during surgery - 35 sec.

5. Resection of P2 section from the mitral valve - 1:19 min.

6. Mitral valve repair by transposition of chordae - 5:07min.

Dept. of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center