Difference between revisions of "Mitral valve repair or replacement"
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Mitral valve repair or replacement is performed for severe mitral regurgitation (MR), mitral stenosis (MS), or mixed disease. Repair is preferred when possible because it preserves annular-ventricular continuity, maintains LV geometry, improves long-term survival, and avoids prosthetic complications. Replacement is performed when repair is not durable or technically feasible (severe calcifications, rheumatic disease, extensive endocarditis). | |||
== Overview == | == Overview == | ||
=== Indications<!-- List and/or describe the indications for this surgical procedure. --> === | === Indications<!-- List and/or describe the indications for this surgical procedure. --> === | ||
* Symptomatic severe primary MR | |||
* Severe secondary MR with persistent symptoms despite GDMT | |||
* Severe MS with symptoms or pulmonary hypertension | |||
* Endocarditis with structural destruction | |||
* Concomitant need during CABG or other valve surgery | |||
=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> === | === Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> === | ||
Revision as of 07:52, 2 March 2026
Mitral valve repair or replacement
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Mitral valve repair or replacement is performed for severe mitral regurgitation (MR), mitral stenosis (MS), or mixed disease. Repair is preferred when possible because it preserves annular-ventricular continuity, maintains LV geometry, improves long-term survival, and avoids prosthetic complications. Replacement is performed when repair is not durable or technically feasible (severe calcifications, rheumatic disease, extensive endocarditis).
Overview
Indications
- Symptomatic severe primary MR
- Severe secondary MR with persistent symptoms despite GDMT
- Severe MS with symptoms or pulmonary hypertension
- Endocarditis with structural destruction
- Concomitant need during CABG or other valve surgery
Surgical procedure
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | |
| Cardiovascular | |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
Induction and airway management
Positioning
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Indications | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
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