Mitral valve repair artificial mitral valve has an elevated risk of stroke. Patients with mechanical heart valves who use warfarin for anticoagulation have to be on long-term anticoagulation therapy. This means they must go to the clinic and have a lab blood draw done, typically once a month but more frequently if the level needs to be closely monitored until it is in the therapeutic range. The therapeutic range for most adults with a mechanical valve is an INR of 2.5–3.5. Finally, artificial tissue valves will wear out – on average lasting between 10 and 15 years, requiring further surgery at an advanced
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.