If you have a leaky or stiff mitral valve, you may need heart surgery. Learn about the different procedures used to repair or replace this valve.
Mitral valve repair and mitral valve replacement are types of surgery to fix or replace a leaky or stiff mitral valve in the heart. The mitral valve is between the left heart chambers (left atrium and left ventricle).
Mitral valve repair and mitral valve replacement may be done as an open-heart surgery procedure or as minimally invasive heart surgery. Sometimes a mitral valve problem may be treated with a catheter-based procedure. The specific procedure used depends on the severity of your mitral valve disease and whether it's getting worse.
In robotic mitral valve repair surgery, a doctor removes the part of the mitral valve that doesn't close properly, as shown in the top image. Stitches are used to connect the valve edges together. A ring, called an annuloplasty band (bottom image), is used to tighten the width of the valve.
Surgery or another procedure to repair or replace a mitral valve may be done if you have mitral valve disease such as:
If mitral valve disease is mild, your health care provider may first suggest regular checkups to monitor your heart health. You may be prescribed medications to manage symptoms.
Sometimes mitral valve repair or mitral valve replacement is done even if you're not having symptoms. Research has found that performing surgery in some people with severe mitral valve regurgitation who aren't having symptoms — rather than monitoring the condition — can improve long-term outcomes.
For people with mitral valve disease, health care providers may often recommend repairing the mitral valve when possible, as it preserves the mitral valve and may preserve heart function.
Mitral valve repair may be done to avoid complications that can occur with mitral valve replacement, such as blood clots due to mechanical valves and biological tissue valve failure.
Possible risks of mitral valve repair and mitral valve replacement surgery include:
Before mitral valve repair or replacement, an echocardiogram and other tests may be done to get more details about your heart condition.
Your care providers will review what to expect during surgery and discuss any concerns you may have.
As you prepare for mitral valve repair or replacement, it can be helpful to talk to your loved ones about your hospital stay and what help you may need when you return home. Your care providers will give you specific instructions to follow during your recovery at home.
Talk to your health care providers about:
Your care providers may recommend that you bring several items to the hospital, including:
During surgery, avoid wearing:
Surgery to repair or replace the mitral valve is done at a hospital by a heart (cardiac) surgeon.
If you need heart surgery for another condition in addition to mitral valve disease, the surgeon may perform both surgeries at the same time.
You'll receive medication to put you into a deep sleep during the procedure (general anesthesia). You'll be connected to a heart-lung bypass machine, which keeps blood moving through your body during the procedure.
Mitral valve repair or replacement may involve:
During mitral valve repair surgery, a surgeon may:
Other mitral valve repair procedures include:
During mitral valve replacement, the heart surgeon removes the mitral valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).
Sometimes, a catheter procedure may be done to insert a replacement valve into a biological tissue valve that is no longer working properly. This is called a valve-in-valve procedure.
After mitral valve repair or replacement surgery, you'll generally spend a day or more in the intensive care unit (ICU). How long you'll stay in the ICU and hospital depends on your specific condition and surgery.
During your hospital stay, you may receive:
Tubes are used to drain urine from the bladder and fluid and blood from the chest. Your care providers will frequently check your blood pressure, breathing and heart rate.
After leaving the ICU, you'll usually be moved to a regular hospital room for several days. If you've had a transcatheter procedure, you'll typically stay in the hospital at least overnight but may not need to be in the ICU. With this approach, there are no tubes needed to drain fluid or blood from the chest.
As you recover in the hospital you'll be asked to:
You'll receive instructions to follow during recovery, which usually includes the following details:
After mitral valve repair or mitral valve replacement, your health care provider will tell you when you can safely return to daily activities, such as working, driving and exercise.
In minimally invasive heart surgery, surgeons access the heart through small cuts (incisions) in the chest, as shown in the top two images. In traditional open-heart surgery, surgeons make a larger incision in the chest, as shown in the bottom image.
Mitral valve repair and replacement surgery may help reduce symptoms and improve quality of life in people with mitral valve disease.
If you had mitral valve replacement with a mechanical valve, you'll need blood thinners for life to prevent blood clots. Biological tissue valves break down (degenerate) over time and usually need to be replaced.
Regular health checkups are needed to make sure the new or repaired valve is working properly. Your care provider may recommend a program of education and exercise to help you improve your health and recover after heart surgery. This type of program is called cardiac rehabilitation.
Following a healthy lifestyle is important to heart health before and after mitral valve surgery. A healthy lifestyle includes: