HealthONE - January 28, 2021

The heart is a complex structure made up of chambers and valves that work together to pump blood and nourish the body. Experts estimate the heart pumps about 2,000 gallons of blood each day and that by age 70, a person’s heart will have beat more than 2.5 billion times. Each component of the heart is vital, so when one of the heart valves does not work properly, medical help often is needed to keep the patient in good health. One of the more common valves to malfunction is the mitral valve-- this valve serves as the gateway between the left atrium and left ventricle.

“When the mitral valve works improperly, a patient’s blood flow is affected. This leads to chronic shortness of breath, weakness and fatigue,” explains Charay Bourne, RN, CNC, CVOR at Swedish Medical Center.  “Left untreated, an improperly working mitral valve can lead to heart failure.”

More than five million Americans have mitral valve disease, and many require surgical intervention to repair the valve. In the past, the repair was only performed through open heart surgery. But now, Swedish Medical Center in Englewood, CO, is providing state-of-the-art mitral valve repair that is done through tiny incisions, without the need for an open-heart procedure.

What is mitral valve disease?

Mitral valve regurgitation occurs when the valve does not close properly and blood is able to leak backwards, affecting blood volume and pressure in the heart. Ultimately, it can create unwanted pressure in the veins leading from the lungs to the heart and even fluid build up in the lungs.  Another type of mitral valve disease is mitral valve stenosis. This occurs when the valve becomes thickened, stiff, or fused, limiting the flow of blood.

Often, patients with mitral valve disease do not experience any symptoms for many years. When symptoms do occur, they may include:

  • Persistent cough
  • Shortness of breath
  • Fatigue
  • Decreased energy
  • Lightheadedness
  • Irregular heartbeat

“If your doctor suspects you have mitral valve disease, further testing will be done to confirm the diagnosis,” Bourne says. “Testing may include echocardiography, echocardiogram, chest X-ray, cardiac MRI and/or stress tests.”

How is mitral valve disease treated?

Typically, symptomatic mitral valve disease requires surgical intervention to repair the valve and prevent further complications. In the past, this correction was achieved through an open-heart surgical procedure. In this procedure, the cardiovascular surgeon makes a large six-to-eight incision down the front of the chest. The breastbone (sternum) is opened, and the ribs are spread apart so the heart can be accessed. Once the heart is accessed, the valve can be repaired in the way that is necessary.  However, recent surgical advancements have provided an alternative to open heart surgery-- minimally invasive, robot-assisted mitral valve repair.

“The development of advanced technology and techniques now allow us to access the heart through tiny incisions,” Bourne details. “The surgeon makes several small incisions through which tiny instruments and robotic arms are placed. This allows us to operate without large, invasive incisions, which means less pain and shorter recoveries.”

What is robotic mitral valve repair?

While robotic heart surgery might sound like the surgeon is replaced with a robot, it is instead simply a highly advanced tool that the surgeon controls. Once the incisions are made (often around the size of a dime), thin tubes are placed into the body through the incisions. These tubes create paths for the robotic arms and instruments. The surgeon then is seated at a console next to the patient. There, the surgeon has full control over the robotic arms. These tools provide more dexterity than the human hand and an incredibly high definition, magnified, 3D image of the inside of the heart. This sharply defined live imagery is 10x stronger than the human eye, giving the surgeon unmatched precision in the repair.

“Not only does the robotic technology allow for a more precise and complete procedure, but it also allows us to protect more of the body from trauma experienced through the surgery,” Bourne highlights. “For our patients, this often means less complications, less blood loss, less pain, a shorter hospital stay, and a faster return to normal activity.”

Bourne encourages patients with the need for mitral valve repair to talk to their surgeon about robot-assisted options or contact a Swedish surgeon to learn more about the procedure.

“It is important to find a facility that is experienced in providing robot-assisted heart surgeries,” Bourne states. “At Swedish, all members of the care team are specially trained to care for patients undergoing this type of procedure and know how to work together to provide the very best outcomes for our patients.”

Learn more about why more patients are saying “Take Me to Swedish” for their emergency and planned heart care needs by visiting us at SwedishHospital.com/er.