Can heart valves be repaired instead of replaced?
Yes — mitral and tricuspid valves can often be repaired rather than replaced, which preserves the native valve and avoids the need for anticoagulation or future reoperation. Mitral valve repair is successful in 95-99% of degenerative MR cases at expert centers. Aortic valve repair is possible in select cases (particularly aortic regurgitation), but aortic valve replacement remains more common. The key factor is surgeon expertise: repair rates vary dramatically by surgeon.
The complete answer.
Valve repair is strongly preferred over replacement when feasible. The ACC/AHA guidelines give repair a Class I recommendation for degenerative mitral regurgitation when performed at a reference center with an established track record. Repair preserves better long-term heart function, has lower operative mortality, and avoids the lifelong anticoagulation required with mechanical valves or the limited durability of bioprosthetic valves. However, not all valves can be repaired — factors like extensive calcification, rheumatic disease, or certain anatomies may require replacement.
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