Question: I have a 'leaky' mitral valve. My doctor wants me to have my valve replaced while I am having my bypass surgery. Is this a good idea?
Answer: A leaky mitral valve is a very important consideration for surgery. Now, if you have an isolated leaky mitral valve, meaning that that's the only disease that you have, and that disease is severe, meaning that the valve leaks severely, or even if it leaks moderately severely, one seriously should consider having that valve repaired -- repaired and not replaced.
The techniques for mitral valve repair are superb, and our ability as surgeons to repair those valves with good results and long-term survival and durability of those valves is now superb. So this is a very, very important consideration.
Now, if you also have coronary artery disease at the time of your, at the time of your surgery, and you've been noted to have a leaky mitral valve, then once again it depends on the severity of that leakage and whether or not it should be performed.
Again, a repair is probably the best route to go, rather than a replacement, because a repair maintains the architecture within your heart. It maintains the connections between the valve and the muscle of the heart.
Think of the mitral valve as a parachute with a canopy, the cords, and the person on the end actually being a little muscle that attaches to the inside of your heart, so maintaining that structure and that architecture is very important for long-term heart function, so surgeons have learned to repair valves with excellent results, and that's really the most important consideration in therapy for someone who has a leaky mitral valve and coronary artery disease.