Surgical treatment for mitral valve disease includes either repairing the patient's diseased valve or replacing it with a metal, mechanical valve or an animal tissue valve. The majority of those procedures are open-heart operations that require a major incision in the chest. Now, after a six-year study, surgeons at the University of Maryland Medical Center in Baltimore conclude that minimally invasive mitral valve repair techniques, through only a two-inch incision in the right side of the chest, are safe, durable and effective. The results are published in the September 2009 Annals of Surgery.
"Our experience with 187 patients demonstrates that small-incision mitral valve surgery can be performed safely and effectively with a short hospital stay and a rapid recovery," says lead author James S. Gammie, M.D., a cardiac surgeon at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine.
The most common complications from mitral valve surgery are stroke, kidney failure and infections, none of which occurred among the 187 consecutive patients who received the minimally invasive procedure at the University of Maryland Medical Center, beginning in 2003. Echocardiograms taken just prior to discharge, which were read by cardiologists who did not know the method of mitral repair or surgical approach, showed that 99 percent of the repaired valves were working properly. The median hospital stay was four days. All patients survived the surgery and 2 years later, 99 percent of the patients were still alive.
Mitral valve surgery was first performed in 1960, when surgeons replaced the diseased, native valve with an artificial valve. For the next 20 years, replacement with a metal or animal tissue valve was the gold standard. Dr. Gammie says no device is as good as a patient's own valve. The metal valve tends to form blood clots, which can lead to a stroke, so patients mu
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University of Maryland Medical Center