Patients with mechanical heart valves are required to take blood thinners for the rest of their lives, which presents a risk of bleeding complications.

This means they must go to the clinic and have a lab blood draw done, typically once a month but more frequently if the level needs to be closely monitored until it is in the therapeutic range.

[2] Finally, artificial tissue valves will wear out – on average lasting between 10 and 15 years, requiring further surgery at an advanced age.

In the past two decades, some surgeons have embraced surgical techniques to repair the damaged native valve, rather than replace it.

A repair still involves major cardiac surgery but for many patients presents the significant advantage of avoiding blood thinners and may provide a more durable result.

However, some studies suggest that blood thinners like Warfarin can reduce a “composite of bleeding and thromboembolic complications” and potentially postoperative complications, as those taking Warfarin have shown “superior long-term survival estimates.”[3] Not all damaged valves are suitable for repair; in some, the state of valve disease is too advanced and replacement is necessary.

The traditional surgical approach to a mitral valve repair is a full or partial sternotomy, in which the surgeon cuts through the breastbone at the center of the chest to access the heart.

In the 2000s there have been several trials of a newer strategy of mitral valve repair that does not require major cardiac surgery.

[6][7] As early as January 2000 a team of doctors[8] at the Instituto de Cardiología y Cirugía Cardiovascular in La Habana, Cuba have performed beating heart mitral valve repair or replacement.