Mitral Valve Replacement/Repair

If you have mitral valve disease and require valve replacement surgery, your damaged valve may be:

  • Replaced with a mitral mechanical valve
  • Repaired with an annuloplasty ring or band 
  • Replaced with a tissue valve

Mitral Mechanical Valves

Mitral mechanical heart valves (sometimes inaccurately referred to as "metal" valves) are made from biocompatible materials such as titanium or pyrolytic carbon and offer long-term durability that can reach 100 years. The first bileaflet mechanical valves were implanted in 1977. Since then, technology and design advancements to mechanical heart valves have made them an extremely reliable, safe and effective alternative for patients.

The most commonly used mechanical valve is the “bileaflet” valve with two semicircular leaflets that open to allow blood to flow freely in one direction and close to prevent regurgitation (flow of blood back through valve).

Open pivot mitral mechanical heart valve

Mechanical Valves, Advantages and Disadvantages

Durability: Mechanical valves provide excellent long-term durability, decreasing the need for replacement surgeries. Mechanical valves are a good choice for younger patients, particularly children and adolescents who are prone to higher failure rates with tissue valves.

Anticoagulation: Long-term anticoagulation therapy is needed with mechanical heart valves. Mechanical valves should not be prescribed for women who are pregnant or plan on getting pregnant and cannot take anticoagulants (blood thinners).  Oral anticoagulant therapy has been used for half a century and are efficient in preventing or delaying the clotting of blood.1 Coumadin®, the most common of these drugs, is listed as one of the 20 most frequently prescribed drugs in the United States.


Mitral Valve Repair

The decision to repair a diseased mitral valve rather than replace it depends on the type and extent of valve damage, a patient’s general physical condition, and other health issues. Often, the decision is determined by the cardiac surgeon during surgery when the extent of valve damage can be more clearly assessed.

Mitral valve repair is most often performed to separate fused valve leaflets or to repair or reshape parts of the valve such as a leaflet or chordae tendinease and pallillary muscles. Repair provides structural support, and may involve replacing or shortening the chords that support the valves. When chords and muscles are the right length, valve leaflet edges meet and eliminate the leak. Repair is typically not chosen for valves damaged by calcium deposits or rheumatic disease.

A typical mitral valve repair includes the use of an annuloplasty ring or band to help restore the valve annulus to its proper size and shape, and to support the repaired valve. Annuloplasty rings/bands vary in size, shape, and flexibility to accommodate a variety of patient needs and anatomies.

Various types of rings and bands used for mitral valve repair.

1. www.ncbi.nlm.nih.gov/pmc/articles/PMC2000654/

Coumadin is a registered trademark of Bristol-Myers Squibb.