Expert Insights: Understanding Minimally Invasive Mitral Valve Repair

*Join us as leading cardiac surgeon Professor Jürg Grünenfelder explains mitral valve surgery. Learn about the minimally invasive procedure, typical recovery times, and what to expect regarding life expectancy after this vital heart repair.***Peter Zombori:** Welcome, everybody. Today we're discussing heart valve surgery, and I'm thrilled to have one of the best surgeons in Switzerland—perhaps even the world—Professor Grünenfelder, here with us. Thank you for joining. Our topic today is mitral valve surgery, and we'll be explaining the procedures and answering some common questions surrounding the entire field of mitral valve surgery.**Prof. Jürg Grünenfelder:** Thank you for having me.**Peter Zombori:** So, Professor, let's start by discussing the mitral valve surgical procedure itself. Could you explain what you actually do during this surgery?**Prof. Jürg Grünenfelder:** Of course. In cases of mitral valve disease, patients undergoing surgery usually have **severe** **mitral valve insufficiency**, meaning the valve is leaky. This causes blood to flow backward into the lungs, leading to problems for both the lungs and the heart if left untreated. What we typically do is try to **repair the mitral valve**. This involves suturing the two leaflets of the mitral valve according to the patient's anatomy and sometimes implanting additional cords to make the valve competent again.We usually perform this procedure **minimally invasively**. This means we no longer have to open the chest bone. Instead, we make an incision on the right side, far from the chest bone, and go between the ribs into the chest to operate on the mitral valve. Of course, we need to use a heart-lung machine for this, which is installed through the groin. This allows us to stop the heart and then repair the valve.**Watch the full video here:**It's a significant advantage for the patient because the trauma is minimized with this small incision, about four to five centimeters between the ribs. Patients experience minimal pain, usually for only a day or two, and then it's gone. They can be rehabilitated and return to work much quicker than they would with a full sternotomy, which is the traditional method of opening the chest bone.**Peter Zombori:** That's fascinating. Speaking of recovery, in my research, what people seem most interested in is the recovery time. I'm assuming that with a minimally invasive approach, the recovery is much faster, right?**Prof. Jürg Grünenfelder:** Absolutely. Since it's a small incision, we don't cut bones or articulate ribs, so the trauma and pain are significantly less than with conventional surgery. That's why patients typically go home after four or five days. However, in Europe, we tend to follow patients a little more closely than in the United States. We want to ensure patients don't have to return for any other reasons. So, we usually wait four or five days before sending them home. Here in Switzerland, we also have the option of sending patients to a rehabilitation facility, which we believe greatly speeds up recovery and helps them return to work earlier.**Peter Zombori:** How long would rehabilitation at a specialized center typically last?**Prof. Jürg Grünenfelder:** Usually, the program lasts for two to three weeks.**Peter Zombori:** Okay. So, the total downtime is about three to four weeks. I have one last question, and this is probably the most frequently asked question we found in our research: What is the life expectancy after mitral valve surgery? I know it's probably not easy to answer, but...**Prof. Jürg Grünenfelder:** That's a difficult question to answer precisely because every patient has their unique story and underlying health conditions. But, generally, if we operate on a patient who solely has mitral valve insufficiency, which is the most common condition, they typically have a **normal life expectancy**. It's crucial that the surgery is performed in a high-volume center by experienced hands, as a good repair usually lasts forever. Patients generally do not need a second operation.