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Mitral Valve

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Catheter Based Valve and Aortic Surgery

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Abstract

There are over 210,000 mitral valve operations performed in the United States every year with over 50 % of these patients undergoing mitral valve replacement. Despite shorter durability compared to mechanical valves, bioprosthetic valve usage has continued to rise. This is related to advancements in surgical valve technology, patient preference, and avoidance of long-term anticoagulation [1]. Bioprosthetic structural valve degeneration (SVD) can overtime lead to valvular regurgitation, stenosis, or mixed pathology. It occurs via a variety of mechanisms including leaflet perforation, leaflet tears, commissural tears, cuspal detachment, and restricted leaflet motion. Leaflet dysfunction is most commonly related to collagen degeneration and dystrophic calcification within the bioprosthetic tissue. The true incidence of bioprosthetic valve failure is likely underreported in the published literature and varies greatly between studies. In general, younger patients (less than 65 years of age) have much higher rates of SVD compared to their older counterparts and reoperation more frequently. A number of publications have done subgroup analysis to determine the effect of age at time of surgical mitral valve replacement on the rate of SVD. Table 18.1 shows the differences of published rates of SVD based on age at time of valve implantation. Although older patients have lower rates of SVD compared to their younger counterparts, it still occurs at relatively high frequency. These high rates of SVD in combination with good long-term survival after initial mitral valve surgery has led to increasing numbers of patients requiring reoperations.

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Authors and Affiliations

  1. Department of Cardiology, St. Thomas Hospital, 4220 Harding Pike, Nashville, TN, 37205, USA

    M. Andrew Morse MD, Rick Meece ACS, RDCS, RCIS, FASE & Evelio Rodriguez MD

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  1. M. Andrew Morse MD
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  2. Rick Meece ACS, RDCS, RCIS, FASE
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  3. Evelio Rodriguez MD
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Correspondence to Evelio Rodriguez MD .

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Editors and Affiliations

  1. Department of Surgery, Advanced Cardiac Valve Center, Universit, Charlottesville, Virginia, USA

    Gorav Ailawadi

  2. Department of Surgery, University of Virginia, Charlottesville, Virginia, USA

    Irving L. Kron

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Morse, M.A., Meece, R., Rodriguez, E. (2016). Mitral Valve. In: Ailawadi, G., Kron, I. (eds) Catheter Based Valve and Aortic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3432-4_18

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  • DOI: https://doi.org/10.1007/978-1-4939-3432-4_18

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