Mitral Valve Replacement

Mitral valve replacement is surgical replacement of the mitral valve. Many mitral valves can be repaired, especially if they leak from wearing out. When the valve is too damaged to repair, the valve must be replaced. Valves damaged by rheumatic disease often must be replaced. An artificial (prosthetic) valve is used to do this. Three types of prosthetic valves are available:

  • Mechanical valves made entirely from man-made materials.  

  • Donor valves made from human donors. These are only used in special situations.  

  • Biological valves made from animal tissues.  

LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:

  • Any allergies you have.  

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.  

  • Previous problems you or members of your family have had with the use of anesthetics.  

  • Any blood disorders you have.  

  • Previous surgeries you have had.  

  • Medical conditions you have.  

RISKS AND COMPLICATIONS

Generally, mitral valve replacement is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • Blood clotting caused by the new valve. Replacement with a mechanical valve requires lifelong treatment with medicine to prevent blood clots.  

  • Infection in the new valve. Infection is more common with valve replacement than with valve repair.  

  • Valve failure. Valve failure is more common with valve replacement than with valve repair. Pig heart valves tend to fail after about 8 to 10 years.  

  • Effects from the surgery itself, such as bleeding, infection, and risks of anesthesia. These risks are rare.  

BEFORE THE PROCEDURE

  • You may need to have blood tests, a test to check heart rhythm (electrocardiography), or echocardiography to evaluate your heart valves and the blood flow through them.

  • Ask your health care provider about changing or stopping your regular medicines.  

  • Do not eat or drink anything for at least 8 hours before the surgery. Ask your health care provider if it is okay to take any needed medicines with a sip of water.  

  • Do not smoke for as long as possible before the surgery. Smoking can increase the chances of a healing problem after surgery.  

PROCEDURE

There are two types of mitral valve replacement surgeries:

  • Traditional mitral valve replacement surgery. You are given medicine to make you sleep (general anesthetic). You are then placed on a heart-lung bypass machine. This machine provides oxygen to your blood while the heart is undergoing surgery. The surgery generally lasts from 3 to 5 hours. During surgery, the surgeon makes a large cut (incision) in the chest. Sometimes the heart is cooled to slow or stop the heartbeat. The damaged mitral valve is removed and replaced with a prosthetic heart valve. After the replacement valve is sewn in, the sac around the heart and the chest are closed.  

  • Minimally invasive mitral valve replacement surgery. This is done through a smaller incision. The chest is not opened as in traditional surgery. If your condition allows for this procedure, there is often less blood loss, less pain, a shorter hospital stay, and faster recovery compared to traditional surgery.  

AFTER THE PROCEDURE

Recovery from heart valve surgery usually involves a few days in the intensive care unit (ICU) of a hospital.