In some instances it will be necessary to perform heart surgery in order to repair the mitral valve if it is experiencing a malfunction. The mitral valve malfunction will typically take the form of stenosis, which refers to a narrowing, or of regurgitation, which refers to a leakage. These malfunctions are typically the result of either a congenital abnormality, something the person has had since birth, or from an acquired disease which may occur with aging. Another possible causes of mitral valve malfunction is rheumatic fever. In rare cases the mitral valve may be destroyed as a result of a serious infection or a bacterial endocarditis. The leakage or regurgitation may also be a result of ischemic heart disease, also known as coronary artery disease.
Repair of a Stenotic (or narrowed) Mitral Valve
In the instance of a stenotic, or narrow, mitral valve a repair called mitral commisurotomy may be performed. Once again this valve malfunction may be the result of damage by rheumatic fever or as a condition the person had since birth. Nowadays most cases of rheumatic mitral stenosis are treated by a technique called balloon valvuloplasty. This procedure is performed in a cardiac catheterization laboratory and is done by an interventional cardiologist who uses a catheter with a balloon attached to the end. Once the balloon is in place it expands inside the valve, thereby stretching it further open.
Repair of a Regurgitant ( or leaking) Mitral Valve
More often than stenotic repair is mitral valve repair which is done to correct a regurgitant, or leaking, valve. A congenital mitral regurgitation may be the result of a cleft mitral valve. A cleft mitral valve is one with a cleft or separation down the middle and they are often associated with an atrial septal defect. An atrial septal defect is a type of hole which occurs in the heart between the atria, or low pressure chambers. In some cases these valves can be repaired simply by using sutures to close the cleft.
Another cause of regurgitant mitral valve disease is due to a rupture or elongation of the chordal apparatus. The chordal apparatus is also known as the “heart-strings” and its job is to support the mitral valve. Regurgitant mitral valve disease may also be due to a condition called “floppy valve” syndrome which refers to components of the valve becoming enlarged or elongated due to a more generalized weakness.
Patients who have undergone mitral valve surgery will require a dose of prophylactic antibiotics, used as a preventive measure against infection, whenever they have dental work done.