Cardiothoracic Conditions

Mitral Valve Conditions

Overview of Mitral Valve Prolapse

Mitral valve prolapse is a common condition in which the mitral valve leaflets are floppy or loose. Mitral valve prolapse is diagnosed by echocardiography (EKG) which records the heart's electrical activity. Most patients with mitral valve prolapse do not have a leaky mitral valve and do not require surgery. When a valve with prolapse has a severe leak, surgery should be considered.

 Illustration of the mitral valve

In a normal valve, the flow of blood goes from the left atrium to the left ventricle. Upon closing, it prevents blood from going back into the left atrium. With MVP the flaps fail to close evenly. One or both flaps collapse backwards, sometimes allowing a small amount of blood to leak through the valve.

Mitral valve prolapse, sometimes known as mitral insufficiency or mitral valve regurgitation, is a genetic disorder and seems to affect women three times more than men. It is one of the most common cardiac conditions.

Mitral Valve Prolapse Treatment and Surgical Options

The treatment and surgical options for mitral valve prolapse depend on the severity of the condition, your symptoms and overall health. If you are not having symptoms or if your symptoms are mild, your doctor may suggest medication, lifestyle changes or no treatment at all.

Surgery

If your symptoms become severe, your doctor may recommend mitral valve surgery. The goal of surgery is to allow your valve to open and close properly. There are two common types of mitral valve surgery: valve repair and valve replacement.

With valve replacement, your surgeon cuts out the damaged valve and replaces it with a new, artificial valve. The new valve may be mechanical (from man-made materials) or biological (from human or animal tissue). With valve repair, your surgeon rebuilds one or more of the valve leaflets using your own tissue.

Your doctor will fully explain the pros and cons of replacing your valve versus repairing your valve.

During mitral valve surgery, a heart-lung machine is used. This machine temporarily takes over the function of your heart and lungs during surgery. It provides surgeons with a still and blood-free surface during the procedure.

Whether repairing or replacing your valve, surgery may be performed using open surgery through a large chest incision or minimally invasive surgery through a few small incisions.

Open Surgery

During open surgery, doctors make a large chest incision and cut through your breastbone (sternum) to reach your heart. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your chest. Open surgery allows your surgeon to see and touch your heart and tissues. While open surgery allows your surgeon to see and touch your organs, it is invasive due to the large incision.

Minimally Invasive Surgery

Thoracoscopic Mitral Valve Surgery

During thoracoscopically-assisted surgery, doctors repair or replace your defective valve through one or more small incisions instead of a large incision through the breastbone. Long, thin surgical instruments, including a tiny camera, are inserted through the incisions to reach your heart. The camera takes images inside your chest and sends them to a video monitor to guide surgeons as they operate.

da Vinci Mitral Valve Repair Surgery

Another minimally invasive surgical option is da Vinci Surgery. The da Vinci Surgical System uses the latest in surgical and robotics technologies. da Vinci is beneficial for complex surgery. With da Vinci Surgery you avoid the large chest incision used with open surgery.

da Vinci is a state-of-the-art surgical system that features a magnified 3D high-definition vision system and special wristed instruments designed to take surgery beyond the limits of the human hand. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. Physicians have used the da Vinci System successfully worldwide in hundreds of thousands of procedures to date.

 

PN 1002252 Rev B 06/2013


The clinical evaluation of the da Vinci Surgical Systems (Models (S1200, IS2000, IS3000) supporting its use for mitral valve repair was not performed totally endoscopically. Introduction and manipulation of the endoscopic instruments were controlled by the da Vinci Surgical Systems through port incisions (< 1 cm) while accessory technologies, e.g., atrial retractor and cardioplegia line, etc, were introduced through a mini-thoracotomy. Performance characteristics for conduct of totally endoscopic mitral valve repair using the da Vinci Systems have not been established.


Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci® Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

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