Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
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Heart Surgery
Mitral valve repair
What mitral valve repair is, how surgeons reshape the valve with rings, resected leaflets or artificial cords, when repair is preferred to replacement, who is suited, approximate costs in Turkey against the UK, US and Germany, the hospital stay and recovery timeline, risks, and what to ask a cardiac team before travelling.
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
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Mitral valve repair in Turkey: what it is and how the valve is repaired
Mitral valve repair is heart surgery that restores a leaking mitral valve while keeping the patient's own valve tissue. The mitral valve sits between the left atrium and the left ventricle and has two leaflets that close like a pair of doors each time the heart beats. When the leaflets do not meet, blood flows backwards into the lungs (mitral regurgitation), causing breathlessness, tiredness, palpitations and, over time, a stretched heart. In repair, the surgeon reshapes the valve rather than removing it: a diseased segment of leaflet may be trimmed, stretched or broken supporting cords may be replaced with artificial ones, and a flexible ring is stitched around the valve opening to hold the repair. Cardiac teams in Turkey perform repair through a full sternotomy or, in centres with the experience, through a smaller right-sided incision.
This guide explains when repair is chosen, how the operation is done, what it costs compared with the UK, US and Germany, what recovery looks like and how to check a cardiac team. Mitral valve disease is a serious heart condition, so any plan starts with your own cardiologist's reports. For the wider list of procedures see cardiology treatments in Turkey.
When is mitral valve repair recommended instead of replacement?
Where the valve can be repaired, most cardiology guidelines prefer repair to replacement for severe degenerative regurgitation, the type caused by wear or a floppy leaflet (prolapse). The reasons are that the heart's own valve tissue is preserved, the heart muscle usually keeps its shape and function better, and most patients do not need lifelong blood-thinning tablets as they would with a mechanical valve. Repair is less often possible when the valve is badly scarred, calcified or damaged by rheumatic fever, or when infection has destroyed tissue. The decision is made from the echocardiogram: where the leak comes from, how many segments are affected, and how much tissue is healthy. A surgeon can only confirm the plan after reviewing scans, and sometimes a repair is attempted and the surgeon replaces the valve during the same operation if it does not hold. A responsible team will tell you this possibility in advance.
How is mitral valve repair performed, step by step?
The operation is done under general anaesthesia and usually lasts three to five hours. The heart is stopped for a time and a heart-lung machine takes over the circulation, which gives the surgeon a still, bloodless field. Typical steps are:
- The left atrium is opened to reach the valve.
- The surgeon inspects the leaflets and the cords, then corrects the fault: resecting a prolapsing piece of leaflet, adding artificial cords made of a synthetic thread, or sliding tissue to restore a neat closing line.
- An annuloplasty ring or band is sewn around the valve to reduce the opening and secure the repair.
- Water is injected into the ventricle to test that the valve closes, and a transoesophageal echo probe checks the result while the heart is beating again.
Minimally invasive approaches use a small incision between the ribs and special instruments; the repair itself is the same, but the breastbone is left intact. Not every patient is suitable for this route, for example if there are other valve problems or previous chest surgery.
Does mitral valve repair work, and how long does it last?
For degenerative leaks the long-term evidence is among the strongest in heart surgery: in experienced hands most repairs stay competent for many years, and the need for a second operation is uncommon in the first decade. Evidence is more variable when the cause is a stretched heart (functional regurgitation) or rheumatic disease, where the valve may leak again. Surgeon volume matters: studies show better repair rates in teams that perform mitral surgery regularly, so ask how many valve repairs the unit performs in a year and how often the planned repair is achieved. Nobody can promise a lifetime result, and regular echo checks continue after surgery.
Mitral valve repair cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for a private operation including the hospital stay, not hospital quotes. Each hospital confirms its own price in a written quote after seeing your reports.
| Country | Approximate cost range |
|---|---|
| Turkey | €12,000 – €28,000 |
| United Kingdom | €30,000 – €60,000 |
| United States | €70,000 – €150,000 |
| Germany | €25,000 – €55,000 |
What changes the price: open or minimally invasive approach, whether a second procedure (such as a bypass or an atrial rhythm procedure) is done at the same time, the type of ring or devices used, the length of intensive-care and ward stay, and complications that extend the admission. A package normally covers the pre-operative tests, the operation and anaesthetist, intensive care, ward nights, medication and transfers; ask what happens to the cost if you need a longer stay, and get the answer in writing.
Who is a good candidate for mitral valve repair, and who is not?
Candidates are people with significant mitral regurgitation, usually with symptoms or with signs on echo that the heart is starting to enlarge or weaken, and with a valve anatomy that a surgeon considers repairable. Others may need more careful assessment: very frail patients, people with advanced lung or kidney disease, active infection of the valve (endocarditis) or recent stroke. If your cardiologist has advised urgent surgery or you have breathlessness at rest, chest pain or fainting, treat that as an emergency to be handled locally, not a trip to plan. Mild leaks without symptoms are usually watched rather than operated on.
Repair, replacement or a catheter procedure: how do they compare?
Alongside open repair there is valve replacement and, for selected patients, catheter-based edge-to-edge repair with a clip. The choice depends on the cause, your anatomy and your general health, not on a preference for one technique.
| Option | Suited to | Typical limits |
|---|---|---|
| Surgical repair | Degenerative leaks with repairable leaflets | Open heart surgery; the repair may not be possible in scarred valves |
| Valve replacement | Valves too damaged to repair | Tissue valves wear out; mechanical valves need lifelong anticoagulants |
| Catheter edge-to-edge clip | Selected patients at high surgical risk | Residual leak is more common; not suitable for every anatomy |
Aortic valve disease is treated differently; see our guide to replacement of the aortic valve. Some patients with a leaking mitral valve also have narrowed coronary arteries, which are treated with bypass or coronary stenting before or during valve surgery.
What is recovery after mitral valve repair like?
Most patients spend one to two days in intensive care and a further four to six days on the ward, so hospital time is about a week. After a sternotomy the breastbone needs around six to eight weeks to knit; you avoid lifting, pushing and driving during this time, and cardiac rehabilitation walking programmes are advised. Minimally invasive surgery can shorten the hospital stay and the return to normal activity by a few weeks, although the heart itself needs the same time to adapt. The table gives a typical pattern; your surgeon sets the actual timetable.
| When | What to expect |
|---|---|
| Days 1-2 | Intensive care, monitoring, drains and pacing wires removed |
| Days 3-7 | Ward, walking, wound care, echo check before discharge |
| Weeks 2-4 | Home rest, short walks, no lifting; flying only when cleared by the surgeon |
| Weeks 6-12 | Breastbone healed, gradual return to work and driving |
| 3-6 months | Energy returns; follow-up echo with your own cardiologist |
For a trip, plan about ten to fourteen days in Turkey, because you should not fly until the surgeon has checked your wound, rhythm and fluid levels. Longer if complications occur.
What are the risks of mitral valve repair?
Every open-heart operation carries real risk. Recognised risks include bleeding, infection of the wound or the valve, irregular heart rhythm (especially atrial fibrillation), stroke, kidney problems, the repair failing and the valve needing replacement, and, rarely, death. The risk is higher with older age, a weak heart, other illnesses and emergency surgery. The NHS and the American Heart Association both explain that results depend on the surgeon's experience and on the patient's condition before surgery. Ask for the unit's own results for mitral surgery, and how a complication abroad would be handled.
How do I choose a cardiac team and hospital, and what are the red flags?
Look for a hospital with a dedicated cardiovascular surgery unit, a cardiac intensive-care unit with round-the-clock staff, perfusionists, transoesophageal echo, and a cardiologist who will talk with your own doctor. The surgeon should be a registered cardiovascular surgeon who performs mitral repairs regularly. Red flags: a price quoted without seeing your echo report, promises that the valve will definitely be repaired, pressure to travel quickly, no named surgeon, and no plan for follow-up at home. Read how our process works and ask for a plan through our free quote page; the hospital reviews your reports and sends a written plan and price.
Questions to ask the clinic:
- Based on my echo, is repair likely, and what happens if the valve cannot be repaired?
- How many mitral repairs does the surgeon perform each year?
- Is a minimally invasive route possible for me?
- What does the package include, and what if I need a longer stay?
- Who will review my follow-up echo and medication after I go home?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
It is heart surgery that restores a leaking mitral valve using your own tissue. The surgeon trims or supports the leaflets, may add artificial cords and stitches a ring around the valve so that the leaflets close properly again.
For degenerative leaks that can be repaired, guidelines generally prefer repair because the heart's own valve is kept and long-term blood thinners are often avoided. Whether repair is possible depends on your valve anatomy on echo.
Approximate ranges are €12,000 to €28,000 in Turkey, against about €30,000 to €60,000 in the UK. The price depends on the approach, extra procedures and the length of stay; the hospital confirms its price in writing.
In experienced hands, repairs for degenerative disease often last many years and a second operation is uncommon in the first decade. Results vary with the cause of the leak, so lifelong echo checks are advised.
Expect about a week in hospital, six to eight weeks for the breastbone to heal after a sternotomy, and gradual return to work over two to three months. Minimally invasive surgery may shorten this somewhat.
Yes. It is open-heart surgery under general anaesthesia using a heart-lung machine, lasting about three to five hours. Pain is controlled with medication, and most people walk on the first or second day.
In some centres, yes. A small incision between the ribs can be used for suitable patients, leaving the breastbone intact. Previous chest surgery or other valve disease may make it unsuitable.
Risks include bleeding, infection, irregular heart rhythm, stroke, kidney problems and, occasionally, the repair needing revision or the valve needing replacement. Risk is higher with age, a weak heart or emergency surgery.
Plan about ten to fourteen days: roughly a week in hospital plus time for the surgeon to check your wound, rhythm and echo before you fly. Complications can lengthen the stay.
Surgical repair is open-heart surgery that reshapes the valve directly. A clip procedure uses a catheter through a vein to join the leaflets and suits selected patients at high surgical risk; some residual leak is more common.
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