Percutaneous heart valve replacement is an interventional cardiology procedure used to treat valve disease, in which the heart valves leak (regurgitation) or are stiff and narrowed (stenosis). It is less invasive than open heart surgery, and involves a catheter inserted into a vein or artery to direct an artificial heart valve to where it is needed. Unlike conventional valve replacement, valves replaced via catheter cannot be sewn into place.
Mitral valve repair is surgery that can be done with either conventional methods or interventional cardiology. One of the four heart valves, the mitral valve is one between the left atrium (top chamber) and left ventricle (bottom chamber). It ensures oxygen-rich blood moves through the right path in the heart before the left ventricle pumps it out to the body. However, if the flaps of the mitral valve get too loose, the blood leaks backward into the left atrium (mitral valve regurgitation). This can cause symptoms such as irregular heartbeat, dizziness, shortness of breath, fatigue and chest pain.
One of the most common mitral valve repair techniques is to remove some of the loose valve tissue and perform an annuloplasty in which a surgical ring shaped like a “C” is sewn around the circumference of the valve to tighten its base. This allows the valve to have a tight seal when it is closed.
Another common procedure is a valvuloplasty in which a catheter with a balloon at the tip is fed through an artery in the groin up to the narrowed valve. The balloon is then inflated until it reopens the valve.
Other repair techniques include: cutting between the flaps of the valve (if they are stuck together); reshaping the valve flaps so they fit together properly; removing the calcium that has built up around the valve flaps [note: this may be the same as valvuloplasty]; replacing or shortening the tissue cords that support the valve; and patching up holes or tears in the valve flaps.
Valve repair is usually more beneficial to the patient than valve replacement, which is required when valves are diseased beyond repair. Replacement valves are either artificial (made of titanium or ceramic) or made of biological tissue from pigs, cows, horses or humans. Artificial valves are permanent, but require the patient to take blood thinners for life. While biologic valves don’t require blood thinners, they will need to be replaced in 10 to 12 years (NIH) or 15 to 20 years (Cleveland Clinic).