The Mount Sinai Hospital The Mitral Foundation

  • Who Should Perform Your Mitral Valve Repair?

    It is not enough to ask your surgeon for his or her overall repair rate; you will need to know their success rate for the specific problem that you currently suffer. For example, a surgeon may be successful in repairing 90% of all valves, but may be successful in repairing only 50% of Barlow valves. You should proceed with a repair only if the surgeon feels he or she can guarantee a repair with a ...

  • Understanding Outcomes of Mitral Valve Repair

    When it comes to heart valve surgery, always seek a specialist. There is a large body of evidence1 showing that the quality of outcomes is directly related to the volume of specific specialized surgical procedures that a given team performs. That's not just true for surgeons, but for other team members including: anesthesiologists, critical care doctors, and other health professionals.As cardiac s...

  • Operative Mortality and Morbidity

    The operative mortality rate for mitral valve surgery has steadily declined over the past decade, with the current mortality rates reported to the Society of Thoracic Surgery Database in the region of 1.5% for mitral valve repair and 5.5% for mitral valve replacement. There is a suggestion that centers doing large numbers of repairs for degenerative mitral valve disease deliver especially low mort...

  • Mitral Valve Repair vs. Replacement Rates

    Dr. David Adams performing mitral valve repair surgery alongside surgical partner Dr. Ahmed El-Eshmawi.Numerous studies that have compared long term-survival of patients undergoing mitral valve repair or replacement have consistently shown a survival benefit with mitral valve repair. The ‘repair rate’ is thus an important variable. The ideal repair technique should be applicable to over 90% of cas...

  • Long Term Survival

    Figure 1: Comparison of observed and expected survival after mitral valve surgery Figure 2: Survival after mitral valve surgery according to preoperative echocardiographic ejection fraction (EF).When interpreting data on long-term survival, it should be appreciated that available data refer to the outcomes of mitral repair and cardiac surgery as practiced 10 to 20 years ...

  • Failures and Re-operations

    Figure 1: Outcome after mitral valve repair.Failure of repair, defined by recurrence of moderate or severe mitral regurgitation, or re-operation for mitral regurgitation are principal endpoints to evaluate the long-term outcomes of mitral valve repair. Failure rates of mitral valve repair are determined principally by the original dysfunction (posterior leaflet, anterior leaflet and bi leaflet) an...

  • Quality of Life

    Ultimately, the best indication of the successfulness of mitral valve repair for symptomatic patients lies in the quality of life. Because re-operation is a poor indicator of a patient’s status, freedom from re-operation does not necessarily imply a freedom from recurrent mitral regurgitation or symptoms. Similarly, survival does not necessarily imply successfulness of surgery. Several series have...

  • Non-surgical Management

    Figure 1: Cardiac events among patients with asymptomatic mitral regurgitation and medical management according to the EROAs current existing guidelines do not recommend surgery for asymptomatic or mildy symptomatic patients1, there is a large cohort of patients with significant mitral regurgitation that do not undergo surgery, thus allowing for observational studies of outcomes in non-surgically ...

  • Mitral Valve Replacement

    An artificial mitral valve after removalMitral valve replacement has been superseded by mitral valve repair as the treatment of choice for all forms of mitral regurgitation. Figure 1: Survival after mitral valve repair or replacement compared with expected survival.There are several reasons to prefer a mitral valve repair to a replacement (such as avoidance of anticoagulation, lower risk of endoc...

  • Expertise in Re-operations and Re-repairs

    One main area of expertise of our valve repair team is cardiac re-operations - performing repeat cardiac surgery on patients who have had previous heart surgery. These patients fall into three main groups. Patients who have had previous operations unrelated to the heart valves but now have a heart valve problem. A typical example would be a patient who has had coronary artery bypass surgery in the...