Mitral Valve Surgery

Abstract

The mitral valve consists of the mitral annulus, anterior and posterior mitral leaflets, anterolateral and posteromedial papillary muscles attached to mitral leaflets with chordae tendineae, and the left ventricle. Any condition or pathological process involving one or more of these components will affect proper functioning of the valve. A degenerative mitral valve disease process is commonly followed by functional mitral regurgitation. Rheumatic heart disease involving the mitral valve is not common in developed countries but is the most common cause of mitral disease in developing countries. A surgical procedure involving the mitral valve requires a thorough understanding of the physiology of a normally functioning valve as well as the mechanism of pathological processes affecting the valve. Mitral regurgitation is more common than mitral stenosis, and mitral valve repair is a preferable technique over replacement of the valve due to less chance of endocarditis, no thrombolytic therapy requirement, and maintenance of normal physiology of the valve. Anesthesiologists providing care for these patients in the operating room play a pivotal role in successful mitral valve procedures by determining the primary mechanism of the pathology, recommending if the valve is repairable, and evaluating the success of the surgical intervention.