The letter M shows the position of the mitral valve in the heart
In mitral valve regurgitation the valve has become loose thereby allowing blood to flow in the wrong direction
DIAGNOSES-OPERATIONS
 

MITRAL VALVE REGURGITATION OR PROLAPSE

The revolution in heart valve operations has come from the advent of the Heart Team, a group of specialized physicians dealing with all aspects of the heart – cardiac surgeons, interventional cardiologists, echocardiographers, cardiac anesthesiologists, vascular surgeons and cardiac radiologists.  This team analyzes all of the patients data and recommends a solution that is customized for the specific patient.  The heart team at HYGEIA Hospital is one of the few teams worldwide that performs operations that are cutting-edge, oftentimes with technology that is not available to all physicians (in the setting of a clinical trial).  This gives us the opportunity to provide solutions for patients who have been told that they are inoperable. 

Of paramount importance is the unique Hybrid Operating Room at HYGEIA Hospital which is the first in Greece. The Hybrid Operating Room is an operating room of the highest technological specifications which is modified to be able to carry out both classic “open” operations as well as endovascular and transcatheter operations which are performed with a simple needlestick and without any incisions.  

Dr. Pattakos is the co-organizer of the well-known conference “Transcatheter Heart Valves Greece” which is attended by international experts in cardiology and cardiac surgery to discuss the latest developments regarding heart valves.  For further information please visit www.thvgreece.com

VALVE REPAIR OR VALVE REPLACEMENT?
Heart valve operations are divided into those which repair the valve and those which replace the valve if it cannot be repaired.  The anatomic characteristics of each valve help the surgeon decide which of the two choices is best for each patient.

SELECTION OF MECHANICAL OR BIOLOGICAL VALVE
For patients who require a valve replacement there is a choice to be made about whether to receive a mechanical (also known as metallic) valve or a biological valve. 
A mechanical valve can function for multiple decades but the drawback is that patients require blood thinners.  The patient who takes these blood thinners requires frequent laboratory evaluation of their levels.  They must also eat stable quantities of foods that contain Vitamin K as this vitamin influences the clotting process. There is also an estimated 1-2% risk of clotting of the valve or bleeding anywhere in the body.

Biological valves do not require blood thinners but they have an approximately ten year lifespan (longer for older patients and shorter for younger patients). When the valve starts to dysfunction this usually happens gradually and patients perceive symptoms and must usually receive a second operation.  This second operation can be performed either with open surgery or, in some cases, with a catheter using a small puncture in the groin.  

WHAT IS IT?
The mitral valve controls the flow of blood from the lungs and left atrium towards the left ventricle which will pump the blood out to the body.  In mitral valve regurgitation the valve has become loose and it will permit flow back towards the lungs instead of keeping the direction of flow forward towards the body.  

WHAT ARE THE CAUSES?
Mitral valve regurgitation is most frequently due to degeneration of the valve because of certain changes in the valve’s structural composition that occur with time.  Very often these changes can occur in very young patients.  Other causes of mitral valve regurgitation include myocardial infarction (heart attack), rheumatic fever, endocarditis (an infection of the valve), atrial fibrillation as well as some cardiomyopathies (diseases of the heart muscle itself). 

SYMPTOMS
Since the blood flows towards the wrong direction and towards the lungs the patient usually complains of difficulty breathing with exertion. Other symptoms include dizziness, easy fatigue and a feeling of heart fluttering. 

OPERATION
For most cases of mitral valve regurgitation, the best outcome will be provided by a repair of the existing valve as opposed to its replacement. The benefits of mitral valve repair are multiple and mainly translate to an increased quantity and quality of life for the patient.  The operation can also be performed using less invasive methods (thoracoscopic, endoscopic, robotic) and the patient will enjoy a faster recovery time, an excellent cosmetic result and above all have the best result for their health. 

Dr. Pattakos has extra training in mitral valve repair having operated and gained experience from some of the top valve repair surgeons in the world (Dr. Patrick Perier, Dr. Peyman Sardari Nia, Dr. Joseph Lamelas, Dr. Tomislav Mihaljevic).  The method he uses, without sternotomy, provides the best possible health benefit with the minimum possible pain and recovery time.  
Attending Surgeon 2nd Department of Cardiac Surgery
Assistant Director Division of Transcatheter Heart Valves
HYGEIA HOSPITAL

Erithrou Stavrou 4, Marousi
210 6867639, 210 6867640
gregpattakos@yahoo.com
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