Cardiothoracic Surgery

Mitral Valve Repair/Replacement

Doctor cupping a plastic heart in his hands

The mitral valve sits between the pumping and resting chambers of the heart and separates the two. This serves to keep blood moving forward in the HEART, pumping it where it needs to go and preventing backflow.

Because of the important of blood flow in the body, even small malfunctions in a small part of the heart can cause complications. A mitral valve requires medical attention in one of two cases.

The mitral valve is too tight. This often happens when the mitral valve is calcified, hardening so much that blood is unable to flow past it. This is also referred to as mitral valve stenosis.

The mitral valve is too loose. When the mitral valve cannot keep a seal between the chambers of the heart, blood moves backward and slows the flow of blood through the body. This is also referred to as mitral valve regurgitation.

What Is the Difference between Mitral Valve Repair and Replacement?

When a mitral valve is damaged or ineffective, surgical procedures might be necessary for the safety of the patient. This can come down to either mitral valve repair or replacement.

Mitral valve repair involves employing a number of techniques to maintain the patient's original mitral valve. This can include trimming extra tissue around the valve or replacing the leaky chords within the valve with functioning ones. Most surgeons will also place a band around the mitral valve called the annuloplasty ring. This is particularly helpful to patients with mitral valves that are too big. Patients who undergo mitral valve repair retain their original valves.

Mitral valve replacement involves removing the patient's mitral valve with either a biological or a mechanical replacement. A biological replacement is made from animal tissue and serves as a more natural replacement for the human mitral valve. Biological valves do not come with the complications of a mechanical one but MAY need to be replaced approximately every ten years. Mechanical valves, on the other hand, are more durable and last a long time. However, they tend to cause blood clotting and require the patient to take blood thinners for the rest of his or her life. Discuss the pros and cons of both options with your doctor.

What Is the Surgical Procedure for a Mitral Valve Repair or Replacement?

Although mitral valve repair and replacement are different procedures, they require similar beginning steps to allow the surgeon access to the heart. These methods can be made to be minimally invasive in a number of ways.

All patients will be put under general anesthesia. This means the procedure will be completely free of pain and the patient will be asleep throughout the entirety of the surgery.

Most of the time the breast bone will be divided and the patient will be placed on the heart lung machine. then the valve will be repaired or replaced. Occasionally, some patients will be a candidate for a minimally invasive approach. The surgeon will make a small incision under the right breast.

After the surgery, surgeons will close any incision they have made and put catheters in near the heart to drain any fluid that may build up after the procedure.

What Is the Recovery Process After Mitral Valve Repair or Replacement?

The recovery period in the hospital after mitral valve repair or replacement is generally under a week, with one or more days in the intensive care unit (ICU).

Some patients may require catheters to drain blood or urine, while others may require intravenous lines for fluids. A pacemaker might be required if the heart rate is significantly slowed after surgery.

After the hospital stay, doctors will prescribe a decrease in overall activity for four to six weeks. Most patients

How Do I Prepare for a Mitral Valve Repair or Replacement Surgery?

Doctors generally give patients a list of things to do to prepare for surgery. These can include:

Abstaining from food and water for a period of time prior to the surgery.

Wash well with antibacterial soap the night before the surgery, particularly below the neck.

Abstaining from medications like coumadin. Blood thinners can slow recovery times significantly.

Abstain from smoking for a period of at least two weeks.

Prepare for a return from the hospital. This can mean preparing the house for someone who cannot function at full physical capacity or arrange for a friend or family member to assist the patient.

Remember to inform your doctor or healthcare provider of any drugs you are currently taking.

What Are the Risks of Mitral Valve Repair or Replacement?

As with any surgical procedure, mitral valve repair or replacement comes with a number of risks, which made include bleeding, blood clots, STROKE, KIDNEY FAILUE, breathing problems, or infection. Mechanical valves as mitral valve replacements, in particular, are known for causing blood clots and need to be monitored closely.

Overall, mitral valve repair and replacement procedures are extremely safe. Minimally invasive techniques have improved dramatically, and as a result, patients find they recover more quickly and suffer less pain.