Mitral valve disorders
Heart valves are flaps of tissue that ensure that blood entering or leaving the heart moves in the right direction, with no backflow. A heart valve can become dysfunctional in two ways: stenosis or insufficiency.
The mitral valve controls blood flow between the heart and the lungs. If the mitral valve dysfunctions, the lungs can become congested with blood. Excess fluid in and around the lungs causes shortness of breath, and backed up fluid causes swelling throughout the body.
● Mitral valve stenosis occurs when the mitral valve does not open properly. Over time, the mitral valve and supporting structures become stiffer, shorter, and tighter. This makes it harder for the valve to open and the heart to pump blood throughout the body. This disorder is most often caused by rheumatic fever and rheumatic heart disease.
● Mitral valve insufficiency, or regurgitation, occurs when the valve does not close effectively. This can cause blood to be pumped backwards instead of forward, leaking blood into the lungs. This leads to increased fluid in the lungs and can cause high pressures in the arteries of the lungs (pulmonary arteries). If mitral regurgitation is left untreated, the heart becomes weakened, which may lead to heart failure.
Surgical options at Weill Cornell Medicine
Mitral valves can be repaired with surgery. At Weill Cornell Medicine’s Department of Cardiothoracic Surgery, our surgeons are experienced in using a variety of techniques to repair and replace all heart valves, including the mitral valve.
Mitral valve repair: Our surgeons have extensive training and experience, which enables them to repair a large percentage of mitral valves, instead of replacing them with prosthetic valves. We specialize in:
● Repairing the mitral valve using an annuloplasty ring, which shrinks the valve to the normal size and shape. This technique reverses the stretching caused by mitral regurgitation.
● Removing excess tissue in the mitral valve caused by mitral regurgitation and repairing the normal tissue using small sutures (stitches).
● Repairing the mitral valve using a neochordae, a set of synthetic threads connecting the mitral valve to the surrounding structures.
Mitral valve replacement: In some cases, the mitral valve is too damaged to repair. Our surgeons offer state-of-the-art replacement options. We specialize in:
● Chordal-sparing technique to preserve as much of the supporting structures as possible when replacing the valve
● Minimally invasive transcatheter (TMVR) and robotic surgical techniques, which enable us to replace the mitral valve using only small incisions
Why choose Weill Cornell Medicine for mitral valve surgery?
● Access to state-of-the-art imaging technology that allows our surgeons to obtain three-dimensional images of the patient’s heart, which is used to determine the best surgical technique and guides the surgery
● Our record of excellent outcomes
● Our surgical team works with each patient to develop an individualized, comprehensive treatment plan
● Collaboration among a wide range of specialists, which ensures the best possible recovery
We recommend visiting the Weill Cornell Medicine Cardiothoracic Department website, as well as the American Heart Association.
Once you and your care team decide that surgery is the best treatment plan for your condition, you will schedule a pre-surgical appointment, which takes place at M404.
During your pre-surgical appointment:
Your nurse practitioner will explain what you can expect for your specific surgery and hospital stay
Your nurse practitioner will review your current medications
You will sign a consent form for the surgery and potential blood transfusion (Please note: Most patients do not receive blood transfusions during surgery, but we are required to have you sign this consent form, just in case you do need a transfusion and are not awake at the time to give your consent. ALL blood is stringently tested for HIV, hepatitis, and cytomegalovirus.)
You have the opportunity to ask questions
You will receive a small bottle of antibacterial soap
This process generally takes two to three hours.
You will be given instructions as to which medications you should stop taking to prepare for surgery.
On the night before your surgery, shower using half of the bottle of antibacterial soap. On the morning of the surgery, before you come to the hospital, shower using the rest of the soap.
Do not eat or drink after midnight the night before your surgery. You may take your medications that the nurse practitioner approved you to take the morning of surgery, with just a small sip of water.
Parking is available in front of the 68th Street circular entrance to the hospital. There are also several parking garages in the immediate area.
Parking is only validated on the day of your hospital discharge, not on the day of your pre-surgical appointment.
Please be sure to bring you:
Insurance card(s)
Toiletries
Pajamas, robe, and slippers
Generally try not to bring too much to the hospital, because you probably won't use a lot of these things and will just have to carry them home.
Please do not bring any jewelry or expensive electronics with you for the first hospital day. Your family and friends are welcome to bring those items once you are awake and in your room.
Please check in at Greenberg 3-West (Same-Day Surgery Unit), which is on the third floor of the Greenberg Pavilion, using the "G" elevators.
If you are the first case, please check in at 6 AM. If you are the second case, please check in at 10 AM.
The usual length of the actual cardiac surgery is about three and a half to four hours. However, the total length of time your family member will spend in the operating room is longer. Much of that "extra time" is spent preparing you for surgery and getting you ready to go to the recovery room (PACU) or ICU following surgery.
During your surgery, your family and friends should wait in the Ronald O. Perelman Heart Institute Atrium. Please tell them to check in at the front desk so that they can be contacted when your surgeon calls.
If the Ronald O. Perelman Heart Institute Atrium is closed at the time of your surgery, your family and friends may wait in the smaller waiting area right outside the Cardiothoracic ICU (4-West).
There is also a café on the first floor of the hospital, directly opposite the information desk and down the hall from the front door on the left, which is open at all times. This café sells coffee, tea, and a variety of food.
Please download our extensive Guide to Surgery.
Please see Insurance Questionsor call (212) 746-5161.