Everyone knows the importance of heading in the right direction while traveling on a one-way street. And backing up could be disastrous. The same is true for your heart.

“Your circulatory system is like a one-way street with blood constantly flowing in the same direction,” said Stephen Olenchock, Jr., DO, chief of cardiovascular surgery, St. Luke’s University Health Network. “Blood from the body enters and leaves the heart’s four chambers, stopping in the lungs along the way. Four valves regulate the amount of blood in each chamber, opening and closing like a door.”

The mitral valve separates the upper (atrium) and lower (ventricle) chambers on the left side of the heart, which does most of the heart’s work. With each heartbeat, the mitral valve opens while the chamber fills and then shuts tightly. When the heart squeezes, blood is forced from the ventricle though the aortic valve into the aortic artery, which sends blood to the rest of the body. However, sometimes the mitral valve leaks and some blood backs up; this is called “regurgitation.”

“The heart wants blood going through it in the right direction; it doesn’t want blood going backward,” he said. “Mitral valve regurgitation can result in decreased heart function or even heart failure over time.”

“A skilled cardiac surgeon can repair a malfunctioning mitral valve,” Dr. Olenchock said. Surgeons who perform large numbers of mitral valve surgeries have better outcomes in terms of the patient’s quality of life and survival. Also, valve repair may last longer than replacement, minimizing the need for further operations. Considering all cardiac surgeons across the country, the average number of repairs performed each year is five or six, with more than 25 considered high-volume.

Dr. Olenchock repairs 40–45 mitral valves per year. In severe cases, he may replace the mitral valve with one made from cow tissue (bovine valve) or a mechanical option. However, he stressed the importance of repairing the valve whenever possible because no one can make a better valve than your body’s original one. Fixing the patient’s own valve is their best option regarding how they feel, their long-term survival, and reducing complications down the road.

“The mitral valve has a front and back leaflet,” he explained. “I often tell patients that these are like parachutes. The leaflet is like the fabric part of the parachute with cords suspending it to the heart. People may have a torn cord. Then, the material flips up, like when you cut a cord on a parachute. The front and back leaflets do not meet, allowing blood to seep out.”

Dr. Olenchock recalls treating an active runner in his 50s whose only symptom was occasional slight shortness of breath. An echocardiogram (heart ultrasound) showed that he had severe regurgitation caused by a torn cord. The patient had surgery. About three days later, he was ready to go home. Usually, patients also receive outpatient cardiac rehabilitation.

“It’s rewarding when they come back to the office,” he said. “We see them return to their regular activities, running or walking with their spouse without having to stop or be short of breath. The procedure gets the heart back into shape and the patient back to a full life without future restrictions. They’re able to do the regular activities they enjoy.”

Dr. Olenchock encourages patients diagnosed with mitral valve disease to do their homework when selecting a surgeon. Find other patients and talk to them about their experiences. Also, check websites to see if the surgeon has good reviews.

At St. Luke’s, the entire team is experienced in mitral valve surgery, including cardiologists, anesthesiologists, and nurses who cares for patients after surgery. St. Luke’s offers 3D imaging, so Dr. Olenchock can show the patient their heart, mitral valve, how it leaks, and how he will repair it.

“Ultimately, you have to be comfortable with the surgeon during your pre-surgical consultation,” Dr. Olenchock said. “You must feel confident they are making the appropriate recommendation and have the skills to repair your valve. At St. Luke’s, we repair very complex mitral valves. Whether a complicated or easy repair, it truly matters that you have somebody with experience.”

To schedule an appointment with Dr. Olenchock, call St. Luke’s Cardiovascular Surgical Associates at 484-526-3990.