Mitral valve surgery is surgery to either repair or replace the mitral valve in your heart.
Blood flows from the lungs and enters the left atrium of the heart. The blood then flows into the left ventricle. The mitral valve is located between these two chambers. It makes sure that the blood keeps moving forward.
You may need surgery on your mitral valve if:
Minimally invasive mitral valve surgery is done through several small cuts. Another type of operation, open mitral valve surgery requires a larger cut.
Before your surgery you will receive general anesthesia.
You will be asleep and pain-free.
There are several different ways to perform minimally invasive mitral valve surgery.
You may need a heart-lung machine for these types of surgery. You will be connected to this device through small cuts in the groin or on the chest. If you do not need a heart-lung machine, your heart rate will be slowed by medicine or a mechanical device.
If your surgeon can repair your mitral valve, you may have:
You will need a new valve if there is too much damage to your mitral valve. This is called replacement surgery. Your surgeon will remove your mitral valve and sew a new one into place. There are two main types of new valves:
The surgery may take 2 -4 hours.
This surgery can sometimes be done through a groin artery, with no cuts on your chest. The doctor sends a catheter (flexible tube) with a balloon attached on the end. The balloon inflates to stretch the opening of the valve. This procedure is called percutaneous valvuloplasty.
You may need surgery if your mitral valve does not work properly because:
Minimally invasive surgery may be done for these reasons:
A minimally invasive procedure has many benefits. There is less pain, blood loss, and risk of infection. You will also recover faster than you would from open heart surgery.
Percutaneous valvoplasty is can only done in people who are too sick to have anesthesia. The results of this procedure are not long-lasting.
Risks for any surgery are:
Minimally invasive surgery techniques have far fewer risks than open surgery. Possible risks from minimally invasive valve surgery are:
Always tell your doctor or nurse:
You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your surgeon about how you and your family members can donate blood.
If you smoke, you must stop. Ask your doctor for help.
During the days before your surgery:
On the day of the surgery:
Expect to spend 3 - 5 days in the hospital after surgery. You will wake up in the intensive care unit (ICU) and recover there for 1 or 2 days. Nurses will closely watch monitors that display your vital signs (pulse, temperature, and breathing).
Two to three tubes will be in your chest to drain fluid from around your heart. They are usually removed 1 - 3 days after surgery. You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV) lines to get fluids.
You will go from the ICU to a regular hospital room. Your nurses and doctors will monitor your heart and vital signs until you are ready to go home. You will receive pain medicine for pain in your chest.
Your nurse will help start activity slowly. You may begin a program to make your heart and body stronger.
A pacemaker may be placed in your heart if your heart rate becomes too slow after surgery. This may be temporary or permanent.
Mechanical heart valves do not fail often. However, blood clots can develop on them. If a blood clot forms, you may have a stroke. Bleeding can occur, but this is rare.
Biological valves have a lower risk of blood clots but tend to fail over time.
The results of mitral valve repair are excellent. For best results, choose to have surgery at a center that does many of these procedures. Minimally invasive heart valve surgery has improved greatly in recent years. These techniques are safe for most patients, and can reduce recovery time and pain.
Mitral valve repair - right mini-thoracotomy; Mitral valve repair - partial upper sternotomy; Robotically-assisted, endoscopic valve repair, Percutaneous mitral valvuloplasty
Fullerton DA, Harken AH. Acquired heart disease: valvular. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 61.
Webb JG. Percutaneous therapies for structural heart disease in adults. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 59.
Bonow RO, Mann DL, Zipes DP et al. Valvular heart disease.In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 66.
Verma S, Mesana TG. Mitral-valve repair for mitral-valve prolapse. N Engl J Med. 2009; 361: 2261-2269.
Brinkman WT, Mack MJ. Transcatheter cardiac valve interventions. Surg Clin North Am. 2009;89:951-966.
Chandrashekhar Y, Westaby S, Narula J. Mitral stenosis. Lancet. 2009;374:1271-1283. Epub 2009 Sep 9.
Enriquez-Sarano M, Akins CW, Vahanian A. Mitral regurgitation. Lancet. 2009;373:1382-1394.
Updated by: Matthew M. Cooper, MD, FACS, Medical Director, Cardiovascular Surgery, HealthEast Care System, St. Paul, MN. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2015, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.