Heart valve repair is a surgical treatment used to repair one of the four valves connected to the heart. Heart valves can become damaged due to birth defects, heart disease, or infection. The role of the heart valve is to allow blood to flow out of the heart and into various areas of the body, but when a valve becomes damaged, the flap that opens to release the blood may not properly close after the blood exits. This results in blood flowing back into the heart, which is called regurgitation. Alternatively, the valve flap may not open properly and blood cannot exit. This is called stenosis.
Though some valve issues are minor and can be managed or treated with less invasive methods such as medication, some necessitate surgery. The most common problem that leads to surgical heart valve repair is mitral valve prolapse. This occurs when the flap on the mitral valve does not close properly. The aortic valve may also require surgery. The need for aortic heart valve repair is almost always due to regurgitation, and it is performed much less commonly than a mitral heart valve repair. Aortic repair is also more complicated than a mitral heart valve repair. Both types of repair are more desirable than a complete valve replacement as they are typically less invasive and have fewer complications.
Methods of heart valve repair include commissurotomy, which is appropriate for narrowed valves; valvuotomy, which involves the placement of a metal ring around the base of the valve to provide more strength; reshaping, which requires the surgeon to cut out a section, then reattach the remaining pieces; decalcification, which is used to remove calcium deposits; repair of structural supports, which shortens the cords that provide strength to the valve; and patching, which involves using tissue to cover holes in the valve.
Heart valve repair often requires open heart surgery, but less invasive procedures are available in some circumstances. One of these is called a keyhole incision. This procedure allows the surgeon to make a small incision on the side of the chest rather than opening the chest completely along the breastbone. Other surgeons are using robotic machines such as the da Vinci Surgical System, which also greatly minimizes the size of the incision. Both of these techniques reduce recovering time and enable patients to resume with normal activity much sooner than the traditional open heart surgery approach.
