Mitral Heart Valve Replacement Options
Mitral heart valves can be surgically replaced with prosthetic or manufactured heart valves. There are two types of prosthetic heart valves, tissue valves and mechanical valves.
Tissue valves are not as durable as mechanical valves and have a tendency to wear out and require replacement especially for patients younger than 65 years old.1 Some mitral tissue valves have begun to fail as early as 4 years after implant.1 The gradual degradation of tissue valves can cause symptoms to return several years prior to a reoperation to replace the failed valve.
All mechanical valve patients require anticoagulation therapy with the blood thinner warfarin, which creates a risk of bleeding.2 Tissue valve patients usually do not require long-term therapy,3 however, up to 1/3 of patients with a tissue valve require blood thinner for other heart or vascular conditions.4 Even though anticoagulation is not prescribed for all tissue valve patients, there is still a similar risk for complications as there is for properly anticoagulated mechanical valve patients.5
The American Heart Association provides guidelines of treatment options for patients with heart disease. These guidelines3 provide the following recommendation for mitral prosthetic valve selection based on patient age:
|Valve Type||Patient Age (years)|
|Mechanical||preferred option*||reasonable option*|
|Tissue||reasonable option^||preferred option^|
*Unless anticoagulation is not desired, cannot be managed, or is contraindicated.
^A tissue valve is recommended for “any age [patient] for whom anticoagulant therapy is contraindicated, cannot be managed appropriately, or is not desired.”
Shared Decision: The choice of the type of heart valve a patient receives is a shared decision among the patient and his or her doctor.
On-X Mitral Valve
If you are under the age of 70 years and need a mitral valve replacement, ask your doctor about the On-X Mitral Valve.
Mitral Valve Repair
In many cases, diseased mitral valves can be repaired rather than replaced.3 In mitral valve repair, most of the original valve tissue is spared. The structure surrounding the valve is surgically supported and repaired in a way that fixes the shape and function of the valve. Only a heart surgeon can determine if a mitral valve is in good enough condition that it can be repaired rather than replaced.
Minimally Invasive Surgery Options
There are minimally invasive surgical techniques for mitral valve repair and for implanting heart valves, including the On-X Mitral Valve. Ask your doctor if you are a candidate to receive an On-X Mitral Valve with minimally invasive surgery.
- Kaneko T, Aranki S, Javed Q, et al. J Thorac Cardiovasc Surg 2014; 147:117-126.
- van Geldorp M et al., J Thorac Cardiovasc Surg. 2009;137:881-6.
- Nishimura R et al., Circulation. 2017;135:e1159-95.
- Briffa N and Chambers J. Circulation. 2017;135:1101–3.
- Nishimura R et al., Circulation. 2014;129:e521-643.