Standing among the most common cardiac diseases, mitral valve problems cause valve insufficiency and stenosis. Located between the left ventricle and atrium, this valve enables the heart flow to a single direction, preventing a backflow. When something goes wrong and it cannot properly function anymore, some of the blood flows backwards. Since this disease evolves in time, without revealing any symptoms for a long while, its damage to the heart may reach to a moderate or severe level, until it is noticed and diagnosed. Therefore, the treatment steps to be taken afterwards, depend on the severity of the disease.

There are several reasons of the disease: The prolapsus of the valve toward the left atrium, carditis or infarction in the past, rheumatic fever, congenital factors etc. may cause harm on the mitral valve. When the disease comes to a point when it starts to give symptoms, the patient may feel palpitation, shortness of breath, restlessness around the chest and pain and may have complaints like getting exhausted quicker during daily activity.

When patients with these complaints go see a doctor, the physician orders certain tests in order to verify the diagnosis of mitral valve disease. If the tests show that the disease has not reached to a severe level, the patient is treated with medication. However, medication does not treat the disease, it is some sort of a remedy to relieve the complaints. The exact solution for this disease is surgical intervention. Depending on the examination results, the valve must be either repaired or replaced through surgery. In addition to the classical surgery methods, performed through large incisions, mitral valve operations can also be performed using endoscopic and robotic surgery techniques, both of which are performed through small incisions. Also known as minimally invasive methods, these surgical techniques are performed through very small incisions on the armpit or under the breast.

With this method, which can be performed on all age groups, the patient heals more quickly, gets discharged sooner from the hospital and gets back to normal life more rapidly. From the physician’s viewpoint, in treating the mitral valve, the objective is to save the original valve in the first place.

If the problem in hand is the stenosis of the valve, it is broadened through surgical techniques. If the problem is mitral insufficiency, the aim is to treat the prolapsus. If, on the other hand, the valve is severely damaged to be repaired, the solution is to replace it with an artificial valve. There are two types of artificial mitral valves: mechanic and biological. Both options involve different risks. For instance, a mechanic valve is more likely to lead to embolism due to its structure, but is suitable for long-term use. On the other hand, since having a mechanic valve necessitates life-long use of blood-thinner drugs to avoid embolism risk, it is not the best option for mentally disabled patients or patients over 70 and women who are planning to have a baby in the future. With the biological valve, on the other hand, the patient is not required to take blood-thinners since there is no emboli risk. Yet, this valve type has a utilization span of 12 years. The patient may have to undergo another surgery afterwards. For the mitral valve treatment, the doctor should decide on the best method and treatment option after examining the case in hand and evaluating the alternatives.

Repairing the patient’s own valve is the best method, according to the guidelines. Arguing that damaged mitral valves cannot be repaired and that they have to be replaced with a mechanical or bio-prothesis valve is baseless. There are many clinics around the world, where almost all mitral valve regurgitations are repaired. Patients should prefer a team experienced specifically in mitral valve repair operations. Prof. Mustafa Guden’s success rate in all types of mitral valve repair operations is 98%. Only in 2% of the patients, he prefers to perform mitral valve replacement technique.

Since 2006, Prof. Guden has been training his colleagues, both locally and in more than 30 countries, on robotic and endoscopic cardiac surgery techniques concerning mitral valve repair operations.