MITRAL STENOSIS: MS is the disease of the mitral valve, in which there is reduction in the mitral valve area through which blood flows form left atrium to left ventricle. MS is categorized in Mild, Moderate or Severe MS, depending on the area of the valve and flow through the valve is compromised. There are many causes MS, one of the leading cause in our country (India) is Rheumatic Heart Disease(RHD). It is one of the major cause of Atrial Fibrillation (Irregular heart beats). This may cause clot formation in the heart and also distal embolism of the clot to brain or any other part of the body.
Ref Fig. Blausen.com staff (29 August 2014). "Medical gallery of Blausen Medical 2014".
MITRAL REGURGIATION: MR is the disease of the mitral valve commonly known as leaking valve, here when heart relaxed (Diastole) in cardiac cycle this valve does not close properly and this leads to a leak of the significant part of the blood in the upper chamber of the heart. There are many causes of this condition, RHD, degeneration, connective tissue disorder, coronary artery disease(Ischemic). Depending upon the severity of leak it is also divided in Mild, Moderate and Severe MR.
Ref Fig. Blausen.com staff (29 August 2014). "Medical gallery of Blausen Medical 2014".
In combined disease both the lesions exists together . One of them could be more severe.
Dyspnea (breathlessness) on activity.
Orthopnea , breathlessness on lying down.
Paroxysmal nocturnal dyspnea.
Irregular heart beats (AF).
Systemic embolism.
Hemoptysis.
Winter bronchitis.
Infective Endocarditis.
The patients with mild MR may not have any symptoms. Even in severe MR , the patient may not have no or minimal symptoms for years. The patient with Severe MR may have following symptoms: chest pain, dyspnea, irregular heart beats, hemoptysis, paroxysmal nocturnal dyspnea.
These patients may have any symptom listed for MR and MS, depending on the severity of the lesion.
BALLOON MITRAL VALVOTOMY: BMV is a non surgical treatment for Mitral Stenosis. Here a balloon mounted on guide wire is passed through interatrial septum across the mitral valve and balloon is dilated thus increasing the opening of the valve. There are some preop conditions of the mitral valve for successful BMV. It can not be done in all cases.
CLOSED MITRAL VALVOTOMY: CMV is less invasive surgical procedure almost similar to the BMV, it is of historical importance , nowadays it is not done. It is completely replaced by BMV.
OPEN MITRAL VALVOTOMY: OMV or open mitral commissurotomy is a surgical procedure . This procedure is done in the combination of mitral valve repair surgery or alone.
MITRAL VALVE REPAIR: Whenever possible and anatomy of the mitral valve represent a possible and sustainable repair, the mitral valve must be repaired. There are some preop condition of the valve for possible repair.
MVR OR CONVENTIONAL MVR: Mitral Valve Replacement is an open heart surgery. The heart is approached through full Midline Sternotomy that is cutting the breastbone(sternum) in middle. The patient is put on Heart-Lung Machine, Heart is stopped and mitral valve is replaced with the desired valve. The heart is again started. Sternum is closed with stainless steel wires. This is one of safest operation. Mortality rate may be less than 1 or 2%, depending on the preop condition of the heart and lung.
MICS-MVR: MINIMALLY INVASIVE MITRAL VALVE REPLACEMENT is the alternate of the conventional MVR for less invasive, less blood loss, cosmetically well tolerated, less hospital stay, better and early recovery of the patient. In this operation heart approach is through right intercostal space , limiting the size of the incision less than 2 or 3 inches without cutting any bone. This operation is highly dependent on expertise of your treating surgeon. Most of the CTVS surgeons are now adapting this approach rapidly
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