As the valve attempts to close, the leaflets of the valve fail to completely meet, causing blood to leak backwards. Instead of being pumped to the tissues, blood flows back towards the atrium and lungs, which can lead to severe breathing problems. The surgery described here is an attempt to reconstruct the heart valve opening in the enlarged heart so the valve leaflets will meet properly and blood won't leak into the lungs. The success of the procedure in prolonging life will depend on selecting patients with the most severe valve leakage and better preserved heart function. Patients with only mild to moderate leakage and heart failure probably won't benefit from this procedure and may experience further complications, because surgery in this type of heart failure patient is risky.
Heart transplants or a medley of medications used to be the only options for treatment.
But doctors are finding that a new surgery called mitral valve reconstruction can help even severe heart-failure patients, they report. Dr. Steven F. Bolling of the University of Michigan and colleagues have begun the first clinical trial of mitral valve surgery to support preliminary results. Over the past five years, the research team performed the surgery on a pilot group consisting of 118 patients who faced an 80 percent chance of dying within a year if they didn't receive a heart transplant. The patients felt much better, and less than 20 percent died the first year. By the second year still only 30 percent of the group had died, the team reports in the February 1998 Journal of Thoracic and Cardiovascular Surgery .