Mitral Valve Repair and Replacement

Overview

Cedars-Sinai has a long history of performing mitral valve repair operations. Gaining expertise over the last 30 years has made our medical center the largest mitral valve repair center in the Los Angeles area. More than half of our mitral valve surgeries are the preferable mitral valve repairs.

The mitral valve opens and closes, controlling the blood flowing into the left side of the heart. Mitral valve repair may be needed because of aging, damage caused by a heart attack or other disease, or because of an abnormality present from birth.

Whenever possible, a heart valve should be repaired, not replaced. By repairing the valve rather than replacing it, a patient can avoid long-term use of blood thinners and problems, such as an infection.

A mitral valve can also be replaced using mechanical valves, tissue valves or homografts (valves donated by another person).

St. Jude Mitral Mechanical Valve is an example of a mechanical heart valve. Mechanical heart valves have an advantage over tissue valves in that they last a lifetime. More than 90% of all mechanical valves in the United States are St. Jude valves. In more than 20 years of experience at Cedars-Sinai, there has never been a mechanical failure of a St. Jude valve. This is the only mechanical valve currently implanted at Cedars-Sinai. The disadvantage of mechanical valves is that patients will have to take a blood thinner (usually warfarin) for the rest of their lives and have blood tests every four to six weeks.

Tissue valves have a significant advantage over mechanical valves because the patient does not have to take long-term blood thinners. However, most tissue valves have a limited life, with standard tissue valves usually lasting an average of about 15 years. Tissue valves are made from biological tissue, such as from pig heart valves or cow pericardium (the tissue covering the outside of the heart).

The Carpentier-Edwards porcine (tissue taken from a pig) mitral valve is used in patients who cannot have mitral valve repair surgery. This valve has a long record of durability and performance.

With the advent of the mitral homograft, it is now possible to replace diseased mitral valves with a donated human valve that functions similarly to the patient's own valve. Although only a small number of heart patients can use mitral homografts at present, it is another option in patient care.

The Carpentier-Edwards pericardial mitral valve is being implanted at Cedars-Sinai in selected patients. This valve is a new design that is expected to have improved durability over older tissue valves.