The mitral valve is on the left side of the heart. It allows blood to flow from the left upper chamber into the left lower chamber. When the valve is not working well, it may need to be replaced.
Healthy heart valves allow blood to flow one way. Diseased valves either leak and cause backflow, or narrow and restrict blood flow. The condition can be life threatening. Sometimes the valve can be repaired. Other times, it must be replaced.
Rheumatic fever, other infections, defects at birth, and wear and tear are the most common causes of mitral valve problems.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Factors that may increase your risk of complications include:
Talk to your doctor about medications, herbs, or supplements you are taking. You may be asked to stop taking some medications up to one week before the procedure
Do not eat or drink anything the night before your procedure.
General anesthesia is given before surgery. You will be asleep.
An incision will be made along the length of your breast bone. The breast bone will be split lengthwise to expose your heart. You will then be put on a heart-lung machine. This machine takes over the work of your heart so that the doctor can stop your heart.
Your heart will be opened. A substitute valve will be sewn into place. This valve may be mechanical (metal and plastic), such as a St. Jude valve, or it may be made of tissue. Tissue valves most often come from a pig or a cow. Tissue valves may also be supplied by a human donor or even manufactured from your own tissues. When the valve is in place, you will be taken off the heart-lung machine and your heart will be re-started. The incision will be closed.
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Newer techniques, including robot-assisted procedures, are being developed. These procedures will be able to do the same surgery with smaller incisions.
You will be taken to a recovery room. Your blood pressure, pulse, and breathing will be monitored.
About 2-5 hours
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 8-10 days. Your doctor may choose to keep you longer if complications arise.
You will probably spend 1-3 days in the intensive care unit (ICU) and several more days in a regular hospital room. During this time, your care team will:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
Once you get home:
Mechanical valves can last a lifetime. Tissue valves last 7-14 years and then must be replaced. If your valve is repaired and you have no complications, you will likely do well and be able to return to normal activities.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
American Heart Association
The Society of Thoracic Surgeons
Heart and Stroke Foundation of Canada
Mitral valve disease: stenosis and regurgitation. Cleveland Clinic website. Available at: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/mitral-valve-disease. Accessed August 20, 2014.
Mitral valve repair. Society of Thoracic Surgeons website. Available at: http://www.sts.org/patient-information/valve-repair/replacement-surgery/mitral-valve-repair. Accessed August 20, 2014.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed August 2014 by Michael J. Fucci, DOLast Updated: 5/2/2014