Dr. Huynh Hoang Khang, Head of Cardiovascular Surgery at Tam Anh Ho Chi Minh City General Hospital's Interventional Cardiology Center, reported that Mr. Thuc suffered from degenerative mitral valve disease. This condition caused posterior leaflet prolapse and severe regurgitation. Over time, the prolonged volume overload led to dilated heart chambers, reduced cardiac function, and resulted in chronic atrial fibrillation and grade 2-3 heart failure.

Doctor Khang explained that severe, prolonged mitral valve regurgitation causes left atrial dilation and electrical structural changes, making it prone to atrial fibrillation. This irregular heartbeat can lead to blood stasis, clot formation, and an increased risk of embolism.

Mitral valve regurgitation can stem from various causes, including degeneration, calcification, rheumatic heart disease, endocarditis, or myocardial infarction. Mr. Thuc's condition was primary degenerative mitral valve regurgitation, where the valve leaflet prolapsed into the left atrium during heart contraction, causing severe blood backflow.

According to Doctor Khang, timely surgery helps restore heart function. Beyond valve repair, addressing the risk of blood clots associated with atrial fibrillation also reduces the risk of embolism, especially stroke.

The surgical team operated on Mr. Thuc. Intraoperative assessment revealed damage primarily localized to the posterior leaflet of the mitral valve due to degeneration and chordal abnormalities. Since the rest of the valve was relatively healthy, the team prioritized preserving the native valve over replacing it with an artificial one.

During the 4-hour procedure, doctors resected the prolapsed leaflet, reconstructed the valve, adjusted the chordal system, and implanted an annuloplasty ring. This restored the annulus's shape and stability, ensuring proper closure of the two valve leaflets. Concurrently, the team closed the left atrial appendage, a common site for clot formation in atrial fibrillation patients, to reduce the risk of thromboembolism.

Mr. Thuc was extubated 4 hours after surgery. His mitral valve functioned well, and his ejection fraction (EF) improved from 38% to 46%. He was discharged after one week.

Mr. Thuc's follow-up visit with Doctor Khang one week after heart valve repair surgery. *Photo: Tam Anh General Hospital*

Doctor Khang noted that severe mitral valve regurgitation cases warrant intervention. Surgical repair or replacement can restore valve function and prevent further heart damage. When the valve structure is suitable, valve repair is often preferred to preserve the native valve and left ventricular function. However, if a patient experiences severe shortness of breath or significant heart failure, indicating prolonged left ventricular dilation and reduced contractility, the chances of complete recovery after valve repair are limited.

Post-surgery, patients must adhere to treatment and attend regular follow-up appointments. This includes adopting a heart-healthy diet, engaging in appropriate exercise, maintaining a healthy weight, avoiding smoking, and limiting alcohol. Patients also need to effectively manage co-existing conditions like hypertension, diabetes, coronary artery disease, and dyslipidemia to reduce the heart's burden.

Thu Ha

*Patient's name has been changed