Some patients have no choice—their mitral valve is beyond repair and must be replaced. But in many cases, patients suffering mitral valve disease receive replacement valves unnecessarily, and at a significant cost to their long-term health. Why? First, few surgeons are skilled in the challenging art of mitral repair. Second, replacement surgery typically generates higher reimbursements from insurance companies, distorting incentives.
Valve repair is preferable to valve replacement, especially in children, for four main reasons:
1. Repairing Valves Causes Fewer Complications
And mitral valve repair patients enjoy higher long-term success rates relative to patients with replaced valves, even if those replacement valves are made of animal tissue.
2. Replacement Valves Typically Only Last Between 8-10 Years
Subsequent surgeries to replace them become not only inevitable, but much harder and higher risk.
3. A Replacement Valve Won't Grow as a Child Does
A repaired valve—their own tissue—will. If a child receives a replacement valve, he or she will need additional operations to resize and replace it in years to come.
4. People with Mechanical Replacement Valves Must Take Blood-Thinning Medication for the Rest of Their Lives
In addition to the cost and a burdensome monitoring regimen, blood-thinners preclude any activity that might put that person at risk of bruising or bleeding. As a consequence, women on blood-thinners can’t risk getting pregnant, because they would bleed to death in childbirth.