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Mitral valve repair vs replacement

“Repair is always better”

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U-M patient Perry Katsiskas believes she made the right decision in choosing to have her mitral valve repaired versus a future replacement.

Panorea (Perry) Katsiskas’ mitral valve disease didn’t slow her down. A daily exerciser, she lived an active life, relatively free of symptoms. But Perry, like many of the millions of Americans diagnosed with a degenerative version of the disease, was faced with a decision: mitral valve repair vs replacement. In other words, should she have her mitral valve repaired now or wait until her condition required complete valve replacement?

Under the care and counsel of Dr. Francis D. Pagani, surgical director of the U-M Adult Heart Transplant Program and director of the Center for Circulatory Support, Perry chose to have her valve repaired. “Dr. Pagani explained that if and when I experienced symptoms, it would likely be too late,” she says.

“I came in feeling healthy, had surgery and went home feeling healthier,” says Perry. “I felt Dr. Pagani cared about me and my outcome. And the outcome speaks for itself. Early intervention saved the quality of my life.” Dr. Steven Bolling, professor of cardiac surgery, conducts hundreds of mitral valve repairs each year and believes repair is “always better than replacement. The heart’s power is derived from the mitral valve,” he says, noting that if a patient waits for symptoms to warrant replacement, “the heart has already been compromised.” Valve repair, he tells his patients, “will put you back on your natural life survival rate,” as if you had never experienced a heart issue.

Advantages of repair

Perry’s recovery was typical of many patients. She spent five days in the hospital following surgery, with light activity restrictions for three or four weeks. Drs. Pagani and Bolling promote the benefits of having this “minimal access” surgery while a patient is healthy, noting:

  • Reduced risk of complications following surgery
  • Quicker recovery
  • Better preservation of heart function
  • Reduction in the risk of stroke
  • Reduction in the risk of atrial fibrillation

What is mitral valve disease?

The mitral valve controls the flow of blood going in one direction from the lungs to the body. Dr. Bolling describes it as the “heart’s power source.” If the valve does not close properly, or open completely, the heart may have to work twice as hard to do its job, which can lead to atrial fibrillation, embolism, blood clots, stroke and congestive heart failure.

What are the signs?

According to Dr. Pagani, a typical patient with mitral valve disease has been under a doctor’s care for a long period of time. Indications of the need for mitral valve repair include a murmur that has gotten louder or regurgitation that worsens. In these cases, a doctor may recommend surgery to repair the valve. The University of Michigan Cardiovascular Center is the home of one of the largest mitral valve practices in the country. The mitral valve specialists in the Cardiac Surgery Division have successfully repaired mitral valves of thousands of patients.

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The University of Michigan Samuel and Jean Frankel Cardiovascular Center is the top-ranked heart and heart surgery program among Michigan hospitals. To learn more, visit our website at umcvc.org.