Mitral valve replacement replacement include lower surgical mortality (1-2% for repair versus 6-8% for replacement), lower risk of stroke, lower rate of endocardial infection, and improved long-term survival. Patients who receive a valve repair stay on the same survival curve as the normal population. After mitral valve repair, blood thinners are not required; however, lifelong maintenance on blood thinners is required after mechanical mitral valve replacement. Mitral valve surgery can now also be performed robotically although the procedure may take longer. Most patients can endure surgery without complications; however, there are some whose heart functions are too weak to withstand surgery. Non-surgical approaches
Mitral valve prolapse "atrialis", "fibrosa", and "spongiosa". Patients with classic mitral valve prolapse have excess connective tissue that thickens the spongiosa and separates collagen bundles in the fibrosa. This is due to an excess of dermatan sulfate, a glycosaminoglycan. This weakens the leaflets and adjacent tissue, resulting in increased leaflet area and elongation of the chordae tendineae. Elongation of the chordae tendineae often causes rupture, commonly to the chordae attached to the posterior leaflet. Advanced lesions—also commonly involving the posterior leaflet—lead to leaflet folding, inversion, and displacement toward the left atrium. Echocardiography is the most useful method of diagnosing a prolapsed mitral valve.