The research interests of Rakesh M. Suri, M.D., D.Phil., center on advancing the scientific understanding, clinical diagnosis and surgical management of mitral valve disease.
- Determining the optimal timing of mitral valve repair. Dr. Suri's research team has shown that delaying mitral valve repair until the development of symptoms, deterioration in heart function or enlargement in heart size is harmful to patients. The team's data suggest that mitral repair should be considered early in individuals with severe mitral valve regurgitation due to leaflet prolapse. Early repair optimizes the chance for long-term recovery of heart function and survival. Dr. Suri's team has also shown that survival after valve repair is superior to that seen after valve replacement surgery, with long-term durability that is equivalent to mechanical valve substitutes.
- Robotic and minimally invasive valve repair. The use of high-definition imaging systems and robotic technology now allows complex valve repair surgery to be carried out via small incisions with the complete avoidance of a sternotomy. This approach has been shown to be associated with a decreased length of postoperative ventilatory support, shorter hospital stay, decreased postoperative functional limitation and a quicker return to normal activities. Dr. Suri is exploring new ways to perform traditional cardiac surgery through smaller and better tolerated incisions while ensuring that patients benefit from the same durable results offered by traditional "open" chest approaches. With the assistance of the da Vinci robotic platform or thoracoscopic instruments, Dr. Suri and colleagues currently offer minimally invasive procedures to repair the mitral and tricuspid valves, close atrial septal defects, and treat atrial fibrillation. They are also working to develop new methods to perform robotic-assisted coronary bypass surgery and aortic valve replacement in Mayo's robotic laboratory.
- Exploring the cause of myxomatous mitral valve disease. The underlying cause of myxomatous mitral valve disease is poorly understood, and patients often ask, "Why do I have this condition, and are my family members at risk?" The notion that myxomatous mitral valve disease may be caused by an overactive immune system has not been studied to date, but Dr. Suri's team and others have recently identified inflammatory cells in myxomatous mitral valve leaflets as well as protein abnormalities in myxomatous mitral leaflet tissue. These altered proteins may become targets of a normal immune system, causing the body to attack the otherwise normal mitral valve, which leads to weakening and failure of the mitral valve. Understanding this process further will allow us to devise new ways to prevent the onset and progression of myxomatous mitral valve disease.
Significance to patient care
Mitral valve prolapse is one of the most frequent heart valve conditions encountered in the Western world. Estimates suggest that 2 to 4 percent of the general population is affected. Myxomatous mitral valve disease begins and progresses in young healthy individuals, becoming evident only later in life. Mitral valve prolapse is associated with stroke, atrial fibrillation, endocarditis and significant mitral regurgitation. The importance of early diagnosis and effective treatment for this condition is central to restoring normal long-term life expectancy in affected individuals.