The main treatment for mitral valve insufficiency is mitral valve repair. If this treatment option cannot be used, heart valve replacement (prosthetics) will be performed. This operation usually requires a traumatic chest incision. More than 50% of patients, however, have comorbidities that prevent them from safely undergoing surgery. In this case, a minimally invasive procedure can be performed to implant an artificial mitral valve through blood vessels or short chest incisions instead of open surgery. Such operations are safer and less traumatic. These have been developed recently but are already being used at leading German Cardiac Surgery Centers. You are welcome to visit the Booking Health website if you want to treat your mitral regurgitation with minimally invasive replacement surgery. On our website, you will find a list of hospitals that use this technique, see the cost of treatment in Germany, and choose the most suitable medical care program.
- Who may need minimally invasive mitral valve replacement for mitral valve prolapse treatment?
- How is minimally invasive surgery for mitral valve prolapse performed?
- Benefits of minimally invasive replacement surgery for mitral valve prolapse
- Benefits of mitral valve prolapse treatment in Germany
- Organization of mitral valve prolapse treatment in Germany
Who may need minimally invasive mitral valve replacement for mitral valve prolapse treatment?
The mitral valve is located between the left ventricle and the atrium. Normally, blood should move only in one direction, that is, from the atrium to the ventricle, and the heart valve leaflets, which close and completely block the lumen, prevent it from returning. However, if part of the lumen remains, the blood returns and overloads the left atrium. Over time, structural changes progress in the patient's heart, which eventually disrupt its function.
Mild or moderate mitral regurgitation may not be felt by the patient, but if symptoms manifest themselves or severe mitral regurgitation develops, surgery will be required. Without surgical treatment, the mortality rate for patients is up to 5% per year.
Mitral valve surgery is usually performed through an open surgical approach, that is, through a large chest incision. Doctors use a heart-lung machine. The cavity of the heart is opened, after which the necessary manipulations with the heart valves are performed. If necessary, doctors can simultaneously repair or replace several heart valves at once.
Open heart valve surgery is more reliable but, at the same time, more traumatic. Considering that the majority of patients with mitral valve insufficiency are elderly people with chronic diseases not only of the cardiovascular system but also of other organs, open surgery is contraindicated for many of them.
In this case, minimally invasive repair is considered the best treatment option for mitral valve prolapse. It is done through an incision in the groin or through short incisions in the chest. This operation, however, requires a favorable anatomy of the mitral valve. Only a small number of patients are therefore considered candidates for this type of intervention.
Minimally invasive (transcatheter) mitral valve replacement is the last-line treatment option, which is used when no other open or minimally invasive surgery is possible. This procedure can be used in patients with severe mitral valve disease at high surgical risk when open mitral valve replacement or repair surgery is contraindicated and minimally invasive repair is not technically feasible.
How is minimally invasive surgery for mitral valve prolapse performed?
Minimally invasive surgery can be performed using two approaches, depending on which artificial valve and its delivery system are used.
Transapical transcatheter mitral valve replacement is performed through a short incision in the patient's chest. Doctors insert a hollow needle through the apex of the heart and into the left ventricle. A delivery system and an artificial valve are placed through this needle into the heart. It is placed in the mitral position with high-frequency stimulation of the heart.
Transseptal transcatheter mitral valve replacement is performed through an incision in the groin. Doctors catheterize the femoral vein and artery. An artificial valve is delivered to the heart through the blood vessels. Doctors have to make an additional incision in the septum between the atria, but it will later be closed with an occluder.
In any type of minimally invasive surgery, it is more sparing for the patient. Tissue damage is minimal, and recovery times are significantly reduced. If, after an open surgery, it is possible to return to normal life only after 3 months, after a minimally invasive intervention, a person is discharged from the hospital after a few days, and after a few weeks, they feel healthy.
Benefits of minimally invasive replacement surgery for mitral valve prolapse
Transcatheter mitral valve replacement cannot fully replace open-heart surgery. The operation is more effective, but the transcatheter technique is safer and less traumatic.
Minimally invasive mitral valve replacement has the following benefits:
- a lower rate of surgical trauma;
- rapid recovery;
- a low risk of complications in the immediate period of follow-up monitoring;
- a lower patient mortality rate;
- the possibility of performing surgery on patients who are at high surgical risk;
- minimum contraindications.
After transcatheter surgery, the one-year survival rate is higher as compared to open surgery, but the five-year survival rate is lower. However, models of prostheses are constantly being improved. It is possible that in the near future, transcatheter replacement surgery will provide patients with more reliable and long-term results, and in this case, given the higher safety of the intervention, transcatheter mitral valve replacement surgery will begin to displace open interventions, as it once happened with aortic valve replacement surgery.
Benefits of mitral valve prolapse treatment in Germany
A patient who wants to undergo minimally invasive mitral valve replacement will not have much choice of hospitals. It is a rare operation that is performed in a limited number of Cardiac Surgery Centers in developed countries. Minimally invasive mitral valve replacement is also performed in the best German hospitals.
There are a few reasons for you to undergo your treatment in Germany. These are the following:
- cardiac surgeons in Germany have vast experience in performing minimally invasive mitral valve replacement surgery;
- high-precision diagnostics using state-of-the-art equipment allows doctors to perfectly plan the operation and control the course of the surgical intervention;
- the use of the latest artificial mitral valves that are highly likely to provide more reliable and lasting results;
- a low risk of complications;
- high-quality rehabilitation of patients after heart surgery.
Organization of mitral valve prolapse treatment in Germany
You are welcome to use the Booking Health service to have your mitral valve prolapse treated using minimally invasive replacement surgery in one of the German hospitals. Our website has convenient functionality that allows you to choose a hospital based on your diagnosis, treatment method, timing requirements, and cost of treatment in Germany. You can compare prices at different hospitals to find the best option.
When you choose a medical care program through the Booking Health service, the cost of treatment in Germany will be lower for you than if you contact a German hospital directly. The price will be reduced due to the lack of additional taxes for foreign patients.
When you make an appointment for your treatment in Germany through the Booking Health service, you will receive insurance against medical expenses not covered by the program. The initial cost of treatment in Germany will therefore not change for you, even if additional procedures are required.
The specialists at the Booking Health company will help you with the organization of your treatment in Germany. We will find a hospital whose doctors specialize in minimally invasive treatment for heart valve defects and achieve the best results. We will make an appointment for you for your preferred dates, book a hotel room and airline tickets. We will also meet you at the airport and take you to a German hospital by car. After the completion of your treatment, we will take care of your return transfer.
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
ECR - European Cardiology Review
American College of Cardiology