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Avatar universal

Repair or replace mitral valve after earlier replacement of aortic valve

  My husband is 32 years old and in good health other than mitral valve regurgitation which has gotten to the point that something needs to be done.  When he was 18, his aortic valve was replaced with an artificial valve and that valve seems to be working fine.  Now he has a flail leaflet in the mitral valve and we have gotten various opinions regarding whether the valve should be repaired or replaced.  We were told by one doctor that the advantage of repair is to avoid coumadin, but he is already on it for the aortic valve.  Another doctor told us that an artificial valve can cause swelling of the heart chamber and that there is a great advantage to having the existing valve repaired rather than replaced.  This doctor recommended Cleveland Clinic for the repair and before we go to all the trouble to make the trip out there, we were wondering if you could tell us a little more about the pros/cons of both options.  Also, we were wondering what the chances are that another leaflet would break after the repair and he would have to go through the surgery again.
  Thank you.
1 Responses
Avatar universal

Dear Renee, thank you for your question.  Your husband is unique because most patients with mitral regurgitation due to a flail mitral valve leaflet only have mitral valve disease.  As you state, mitral valve repair is best suited for most of these patients since long-term coumadin can be avoided.  A repaired mitral valve is probably slightly better hemodynamically over the long-term than an artificial mitral valve.  An artificial mitral valve can enlarge the left atrium slightly, but that effect is usually not clinically apparent.  Mitral valve repair for a flail mitral valve leaflet is a very durable and successful procedure.  It
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