Mitral Valve Repair
There are four valves in the heart to ensure that blood flows in the right direction. Valves can be either too tight (stenosis) or leak (regurgitation or insufficiency). The mitral valve is located on the left side of the heart between the collecting chamber (left atrium) and the pumping chamber (left ventricle). It prevents blood from being pumped back into the lungs. The mitral valve can leak for a number of different reasons. If the leak is severe enough, surgery should be undertaken to avoid further complications. Most of the time, the mitral valve can be repaired, and often using robotic or other minimally invasive techniques. The goal of the procedure is to restore the mitral valve to its normal shape using the patient’s own valve tissue and to stop blood from leaking backward into the left atrium.
Swedish has long been a center of excellence and training center for minimally invasive cardiac valve surgery. We are one of the few centers in the Western United States to offer robotic mitral valve repair.
Robotic mitral valve repair is done in an operating room, with a team that is specially trained for this robotic surgery
During the procedure:
- The surgeon makes a series of small port incisions on a patient's right side.
- The patient is connected to the heart-lung machine, generally using the large artery and vein for the leg, to provide blood flow to the body when the heart is stopped to complete the valve repair. Access to these blood vessels requires a small incision at the top of the leg.
- A tiny viewing camera and specially designed surgical instruments attached to robotic arms are inserted through the ports in the chest.
- The cardiac surgeon sits at a nearby console, controlling the robot.
- On the console, the surgeon is able to see inside the chest and the heart in 3- D and high-definition, along with up to 10x magnification.
- The surgeon carefully repairs the valve using the same techniques used in a traditional open operation, according to the type of damage causing the mitral valve to leak.
The instruments are "wristed," allowing 7 dimensions of movement, giving surgeons better mobility and dexterity than they would have holding the instruments themselves.
All surgeries involve some degree of risk, and not all patients are candidates for this robotic procedure. If you need mitral valve repair, talk to your doctor about whether you would be a good candidate.
Robotic mitral valve repair is a minimally invasive procedure. After surgery, patients typically return to full activities in about 3 or 4 weeks.
In comparison, patients who have an open surgery (where the breastbone is split and opened widely to allow access to the heart) takes up to 3 months to recover.
Studies to date show that the long-term outcomes for patients who have robotic mitral valve repair match those for traditional open procedures. More importantly, the long-term outcomes are better for patients who have their mitral valve repaired compared to patients who have their mitral valves replaced. Depending on the reason for the mitral valve to leak, Swedish cardiac surgeons have over a 95% success rate in repairing the mitral valve. When necessary, the surgeons at Swedish are also skilled and experienced in robotic mitral valve replacement.
Robotic surgical systems are now widely available, but few cardiac surgeons have the skill, training and experience to perform robotic mitral valve repair.
In choosing a surgeon who performs robotic mitral valve repair, be sure to ask:
- How much experience do you and your team members (anesthesiologist, assistants, nurses, perfusionists and others) have with this procedure?
- How long has robotic surgery been available at your hospital?
- How many robotic surgeries are performed there?
- What is your mitral valve repair rate?
Swedish is a regional center for performing – and teaching – robotic surgery. More than 4,000 robotic procedures have been performed here and everyone on our robotic surgery teams is specially trained and highly experienced. Our surgeons publish and lecture widely, and train other physicians from around the country.