Essentials of Contemporary Mitral Valve Surgery at Cleveland Clinic (Podcast)

Of the 5,800-plus cardiac surgeries performed at Cleveland Clinic annually, more than 1,000 involve the mitral valve. The most common of those is mitral valve repair to treat mitral regurgitation.

In view of the advantages of valve repair over replacement for mitral regurgitation, Cleveland Clinic is able to offer and complete repair in over 99% of its patients with a leaking mitral valve. “The risk of this surgery at Cleveland Clinic is extraordinarily low,” says Marc Gillinov, MD, Chair of Thoracic and Cardiovascular Surgery. “It’s almost like getting your appendix out or a gallbladder operation. The mortality risk of a mitral valve repair operation here is less than 1 in 1,000.”

In a recent episode of Cleveland Clinic’s Cardiac Consult podcast, Dr. Gillinov and cardiac surgeon Per Wierup, MD, PhD, provide an overview of mitral valve surgery at Cleveland Clinic, with a focus on repair. They touch on the following topics, among others:

• Success and safety rates of mitral valve repair
• Growth of, and eligibility for, robotically assisted mitral valve repair
• Other heart conditions that typically can be addressed during mitral valve surgery
• The importance of early intervention for mitral regurgitation
• Durability of mitral valve repair and considerations around re-repair

Click the podcast player above to listen to the 9-minute episode now, or read on for an edited excerpt. Check out more Cardiac Consult episodes at clevelandclinic.org/cardiacconsultpodcast or wherever you get your podcasts.

Excerpt from the podcast

Marc Gillinov, MD: Can you speak to the need for mitral valve re-repair?

Per Wierup, MD, PhD: That’s another area of expertise we have developed here. There have been many mitral valves repaired across the U.S., and there are some patients who come back, for various reasons. That is when re-repair can be considered. In those cases, patient survival is much better if you can re-repair, meaning that the valve is not replaced and the patient keeps their own valve.

We have developed many techniques and published a lot on that. On average, most patients who have a late failure after a previous repair can be re-repaired with much better survival than if they have their valve replaced.

Dr. Gillinov: You’ve looked at our results and the techniques that we’ve come up with. Again, the survival with re-repair returns to that of the normal population, better than replacement.

Dr. Wierup: Yes, and we can do it practically without any mortality.

Dr. Gillinov: Mitral valve re-repair is a procedure we perform routinely at Cleveland Clinic. The patients look just great afterwards, and their echocardiograms show exactly what we’d want to see.