{"id":3242,"date":"2023-06-02T02:02:38","date_gmt":"2023-06-02T02:02:38","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=3242"},"modified":"2023-09-27T19:31:08","modified_gmt":"2023-09-27T19:31:08","slug":"different-faces-mitral-valve-disease","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/different-faces-mitral-valve-disease\/","title":{"rendered":"Surgeon Insights: The Different &#8220;Faces&#8221; of Mitral Valve Disease"},"content":{"rendered":"<p>Mitral valve disease is super complex. From malformed leaflets to annular calcification to endocarditis, there are many different types of mitral valve disorders.\u00a0 For this reason, it is critical that patients understand their specific type of mitral valve disease and the therapies that yield the best, long-term outcomes.<\/p>\n<p>To explore the different types, or &#8220;faces&#8221;, of mitral valve disease, we sat down with <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gerdisch-Indianapolis-Indiana.php\">Dr. Marc Gerdisch<\/a>, the Chief of Cardiac Surgery at Franciscan Health in Indianapolis, Indiana.\u00a0 Dr. Gerdisch is a mitral valve expert who has performed over 5,000 heart valve procedures and successfully treated more than 100 patients in our community.\u00a0 It was fascinating to hear Dr. Gerdisch describe the different mitral valve faces that he sees in the operating room.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/tc3qjdpQTaE?rel=0\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About The Different Faces of Mitral Valve Disease<\/h2>\n<p>The key learnings from Dr. Gerdisch about the different faces of mitral valve disease include:<\/p>\n<ul>\n<li>A common face of mitral valve disease is mitral insufficiency, also known as mitral regurgitation. &#8220;Probably the thing that gets talked about the most is mitral insufficiency, leaking mitral valve,&#8221; states Dr. Gerdisch. &#8220;It\u2019s really the prize of mitral valve surgery in the sense in that nearly 100 percent of those patients will be repaired and will be restored to a normally functioning valve.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-3246 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/completed-mitral-valve-repair-gerdisch.jpg\" alt=\"Completed Mitral Valve Repair in Operating Room\" width=\"650\" height=\"368\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>A complex face of mitral valve disease may include mixed regurgitation with calcification. According to Dr. Gerdisch, &#8220;There are also patients that make up a large swathe outside of standard myxomatous degenerative leaking valves that have either mixed disease, meaning that they have myxomatous disease, that\u2019s classic, degenerative, billowy valves, soft leaflets but they also have, for example, calcification of the valve or they have changes in the architecture of the valve beyond those changes.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-3248 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/mitral-valve-calcification-annulus-operating-room.jpg\" alt=\"Mitral Valve Calcification in Operating Room\" width=\"650\" height=\"364\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>A &#8220;rising face&#8221; of mitral valve disease is extensive calcification from Rheumatic fever. Dr. Gerdisch states, &#8220;We see more and more patients that have extensive calcification of the mitral valve&#8230; As a result of that, the leaflets become thick, immobile. Blocked mitral valves have always been the focus there. If we look worldwide, rheumatic mitral valve disease is still the most common mitral valve disorder. What I\u2019m trying to get at is that someone can have an echocardiogram, it can say the valve is leaking but that doesn&#8217;t mean that it\u2019s a myxomatous degenerative valve. You can have a rheumatic mitral valve that leaks and isn\u2019t obstructed but it\u2019s a function of the leaflets not moving enough, not getting together, not closing properly.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-3249 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/mitral-leaflet-coaptation.jpg\" alt=\"Mitral Leaflet Coaptation\" width=\"650\" height=\"364\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Another rising face of mitral valve disease is overlapping valve leaflets. &#8220;Changes in what we call coaptation, where the leaflets overlap, can be a function of the leaflets being too free to move, so that\u2019s myxomatous degenerative disease. It could be that the leaflets can\u2019t move, and they can\u2019t reach each other, so you don\u2019t have that overlap and that can be the problem. Now, let me give you both. Now, you\u2019ve got one leaflet that moves too much and you\u2019ve got another leaflet that doesn\u2019t move enough.&#8221;<\/li>\n<li>Secondary mitral valve disease presents a different face of mitral valve disease. According to Dr. Gerdisch, &#8220;The other category that I think really mystifies patients, that they can\u2019t really get full information on because it\u2019s difficult to understand is the general concept of secondary mitral valve disease, mitral insufficiency driven by other conditions &#8211; dilated lower chamber, hypertension, coronary artery disease.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-3250 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/mitral-valve-endocarditis-repair-annuloplasty-patch.jpg\" alt=\"Mitral valve endocarditis repair annuloplasty patch\" width=\"650\" height=\"367\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Endocarditis infections are another rising face of mitral valve disease. &#8220;Among the spectrum of disorders, the faces of mitral disease, I did mention endocarditis. Any valve can be infected, and we still strive to reconstruct that valve. Often, we can use whatever tissue is left after whatever destruction has been done by the infection, patch the area that we have to clean out from the infection, reconstruct the valve and then we still re-support it with a valve ring,&#8221; according to Dr. Gerdisch.<\/li>\n<li>Hypertrophic Cardiomyopathy is another rising face of mitral valve disease. &#8220;Other conditions, for example hypertrophic cardiomyopathy. That\u2019s a mouthful but it is basically when people have a very thick heart and then part of that very thick heart obstructs the blood flow getting out of the left ventricle out to the body,&#8221; states Dr. Gerdisch. &#8220;The blood accelerates as it leaves the ventricle. It\u2019s passing by the mitral valve on its way out and the high-velocity jet will actually grab on to the anterior leaflet of the mitral valve and it gets stuck down there. Now, you\u2019ve got to fix that, of course.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-3254 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/Upside-Down-TAVR-In-Mitral-Valve.jpg\" alt=\"Upside Down TAVR in MItral Valve\" width=\"650\" height=\"368\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Dr. Gerdisch will use advanced surgical techniques to address the different faces of mitral valve disease which may include an upside down TAVR in the mitral valve.<\/li>\n<li>The goal of treating mitral valve disease is to repair the valve whenever possible. According to Dr. Gerdisch, &#8220;When we\u2019re approaching a mitral valve that\u2019s complex, we have to orchestrate our thought process around everything about the patient and what we\u2019re doing. It never is one size fits all. When we see varying morphology or changes in the valve, we sometimes have to become creative about how we\u2019re going to go about their repair. It might also move us away from, for example, a minimally invasive repair to doing a sternotomy approach, especially since we do rigid fixation for all the sternotomies. We can give them back their mobility quickly and still repair the valve.&#8221;<\/li>\n<li>Using minimally-invasive techniques should not sacrifice the possibility of a mitral valve repair. Dr. Gerdisch states, &#8220;The other thing you\u2019ve heard me say before is that we never sacrifice a perfect repair for a small incision. We get into the more exotic repairs, we\u2019re taking calcium out, we\u2019re changing more of the architecture of the valve, then we might think of moving over to a larger exposure just because we know that we\u2019re going to get the job done.&#8221;<\/li>\n<li>Dr. Gerdisch advises mitral valve disease patients is to understand their specific type of mitral valve disease, the condition of the heart, and the treatment options available to them. &#8220;My recommendation for the patient is first, any abnormality of any echocardiogram has to be explained and then any change has to be explained,&#8221; states Dr. Gerdisch. &#8220;We really need to become intimate with that, with respect to what it means to the particular patient. The patient has to seek that information from their cardiologist and from their heart surgeon. They have to have a conversation, a dialog.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Many Thanks to Dr. Gerdisch &amp; Franciscan Health!!<\/h2>\n<p>On behalf of our entire patient community, many thanks to Dr. Gerdisch for sharing his clinical experiences and research with our community!\u00a0 Also, many thanks to the Franciscan Health team for taking such great care of heart valve patients.<\/p>\n<p>Related links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/minimally-invasive-mitral-repair\/\">Surgeon Insights: Minimally-Invasive Mitral Valve Repair Surgery<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/rapid-recovery-protocol\/\">Top 5 Facts About Dr. Gerdisch\u2019s Rapid Recovery Protocol<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gerdisch-Indianapolis-Indiana.php\">See 100+ Patient Reviews for Dr. Gerdisch<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the hearing impaired members of our community, I have provided a written transcript of the video with Dr. Gerdisch below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[12],"class_list":["post-3242","page","type-page","status-publish","hentry","category-mitral-regurgitation"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3242","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=3242"}],"version-history":[{"count":20,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3242\/revisions"}],"predecessor-version":[{"id":3363,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3242\/revisions\/3363"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=3242"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=3242"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}