Mitral Valve Repair vs. Replacement: What is the Difference?

Why Valve Repair is Always First Choice

Whenever the valve leaflets and subvalvular apparatus (chordae and papillary muscles) are salvageable, mitral valve repair is superior to replacement. Repair preserves native left ventricular geometry, maintains superior long-term heart function, and eliminates the lifetime requirement for high-intensity blood thinners.

• Annuloplasty Rings: Reinforces and reshapes the dilated mitral valve ring.
• Leaflet Resection or Plication: Trims redundant or prolapsing valve tissue.
• Artificial Chordae (Gore-Tex Neochords): Replaces broken cords supporting the valve leaflets.

When Valve Replacement is Necessary

If the valve leaflets are severely calcified, scarred from rheumatic heart disease, or destroyed by endocarditis, replacement is the safest and most effective solution. Patients and surgeons choose between two prosthetic types:

Mechanical vs. Biological Tissue Valves

Choosing the right valve is personalized based on patient age, lifestyle, and medical considerations:

• Mechanical Valves: Made of carbon alloys. Highly durable and last a lifetime (rarely need re-operation), but require daily lifelong blood-thinning medication (Warfarin/Acitrom) with regular INR blood monitoring.
• Biological (Tissue) Valves: Made from bovine pericardial or porcine tissue. Do not require lifelong anticoagulation, but have a finite lifespan (12–18 years) before degenerating and needing replacement.