Mitral valve replacement
The vortex created from this jetting travels towards the apex of the left ventricle because of the asymmetric shape of the mitral valve leaflets.
Additionally the entire systems; the mitral annulus, papillary muscles and the chordae tendinea all play a vital role in forming a sophisticated vortex that optimizes the fluid flow in the left heart.
Simulations have been performed showing how all of these aspects of the mitral valve contribute to the normal vortex formation in the left heart.
Other causes are mitral degenerative disease, severe calcification (elderly), congenital deformities, malignant carcinoid syndrome, neoplasm, left atrial appendage thrombus, endocarditic vegetations, certain inherited metabolic diseases, or complications of previous procedures at the aortic valve.
As a result, patients with mechanical valves must take blood-thinning medication (anticoagulants) for the rest of their lives, making them more prone to bleeding.
[10] The most common approach for surgeons to reach the heart is a median sternotomy (vertically cutting the breastbone), but other incisions can be employed, such as a left or right thoracotomy.
[19] The valve is excised 4–5 mm from the annulus, leaving intact the attached chordae unless they are calcified or otherwise diseased.
The replacement valve is sewn into the annulus with interrupted or horizontal mattress sutures with the pledgets on the atrial side.
Anticoagulants are taken to prevent blood clots, which can move to other parts of the body and cause serious medical problems, such as a heart attack.
[29] Risks depend on a patient’s age, general health, specific medical conditions, and heart function.
Using echocardiography they quantitatively analyzed the velocity field in the left heart and found that the patients with artificial mitral valves had a consistent counterclockwise circulation, as opposed to the normal clockwise circulation that is characteristic of normal transmitral flow.
[citation needed] To further characterize this counterclockwise circulation a numerical simulation was performed which backed up the data taken from the echocardiograph study.
[citation needed] This flipped vortex circulation could lead to further complications in the patient who had mitral valve replacement surgery as it was observed to cause stagnation points, crossed flows, increased energy requirements and pressure shifts from the lateral to the septal wall in the left heart.
Minimally invasive mitral valve replacement involves a small incision (5–8 cm) just below the right breast.
The benefits of MICS over conventional surgery include reduced hospital stay and blood transfusion requirements, and a smaller scar.
[38][39] Advantages of mitral valve repair over replacement include lower surgical mortality (~1% for repair vs ~5% for replacement[40]), lower rates of stroke and endocarditis (an infection of the heart’s inner lining), equivalent or better long‑term durability,[41][42][43] and improved long-term survival.
[44] In addition, patients may not need to take anticoagulants long term following mitral valve repair.
