Mitral Valve Replacement

Mitral valve replacement is a procedure in which a damaged mitral valve is replaced with an artificial valve. It is located between the left atrium and left ventricle. It aids the flow of blood through the heart and out to the rest of the body. The doctors will install an artificial mitral valve to replace the one that isn't functioning properly. This ensures that blood can flow normally into the left ventricle and out to the body without any additional strain on the heart. The procedure is known to be open because it exposes the heart through a traditional larger incision. The incision used in minimally invasive mitral valve replacement surgery is larger than this one.


Need of an Open Mitral Valve replacement?

Mitral valve replacement depends on the severity of the condition. If you are experiencing any kind of signs and symptoms then the condition may get worse. The doctor and their team will assess to determine the most appropriate treatment for the condition. While evaluating, the doctor will conduct a physical examination to review the medical history and perform further tests.

If you don't have any symptoms or if your condition is mild, your doctor may recommend that you can be monitored with regular assessment. Medications may be prescribed to help and manage your symptoms. For minor conditions, surgery may not be recommended.

However, in serious cases mitral valve needs to be repaired or replaced. In some of the cases, the doctor may recommend mitral valve replacement even if you are not experiencing any symptoms.

If you need any other heart surgery for other conditions in addition to mitral valve disease, then the doctor may prefer the treatment of both conditions at the same time.

Mitral Valve replacement

The doctor will speak to you about whether mitral valve repair or replacement, is the right choice for your case. Mitral valve repair is commonly recommended by physicians. However, if mitral valve repair isn't feasible, doctors will have to rebuild the valve. Doctors can also decide whether you are a candidate for either minimally invasive or open-heart surgery.


Mitral Valve Replacement Risks

People who have an open mitral valve replacement have a positive result, but there can be certain risks in some of the cases. The risks will vary based on overall health, age, and other factors. Possible risks include:

  • Infection
  • Bleeding
  • Irregular heart rhythms
  • Blood clots leading to stroke or heart attack
  • Complications from anaesthesia
  • Continued leaking of the valve
  • Damage to nearby organs

There are certainly other factors that can increase the risk of complications like:

  • Chronic illness
  • Lung problems
  • Being obese
  • Infections

Mitral Valve Replacement Procedure

The doctor and its team will clarify what to expect before, during, and after surgery to get your mitral valve fixed or replaced, as well as any possible complications. Any questions you may have about your condition should be discussed with your doctor and team before the procedure. When you go to the hospital for the surgery, talk to the family about how long you'll be there and what kind of support a patient may need when they get back home. When the patient return home, the doctor and treatment team will give clear instructions to follow throughout the recovery.

Before the Procedure

  • Before the surgery, don't eat or drink anything after midnight.
  • The doctor will ask to stop taking some particular medications. If the patient normally takes blood-thinning drugs like warfarin or aspirin, follow the doctor's instructions.
  • Before an hour of the operation, the patient will be given medicines by the health care provider to get relaxed.

Some regular tests may be required prior to the procedure to determine the health. This may include the following:

  • Chest X-ray
  • Electrocardiogram (ECG)
  • BBlood tests
  • Echocardiogram
  • Coronary angiogram (To access the blood flow in the heart arteries)

During the Procedure

  • Before the surgery, a doctor will prescribe anesthesia. The patient will fall asleep and he/she will not experience any discomfort during the treatment.
  • It will take several hours to complete the procedure. Families and friends can remain in the waiting room so that the surgeon can give them updates.
  • An incision will be made in the middle of the chest by the doctor.
  • A cardiopulmonary bypass machine will be connected to the patient by the surgical team. During the operation, this machine will act as the heart and lungs.
  • The existing mitral heart valve will be removed and replaced with a new valve by the surgeon.
  • The heart-lung machine will be removed by the surgical team.
  • The breastbone will be wired back together by the team.
  • The incision in the skin will then be stitched by the team.

After the Procedure

  • The recovery will begin in an intensive care unit or a recovery room.
  • The majority of people who have a mitral valve replacement report immediate symptom relief.
  • The vital signs will be closely monitored by the team.
  • BA tube can be inserted into the throat to assist in breathing.
  • A chest tube may be inserted to remove excess fluid from the chest.
  • The incision will be covered with bandages. In most cases, these can be replaced in a matter of days.
  • The patient may most likely have to stay in the hospital for 5 days.

After Going Home

  • The stitches or staples will most likely be removed at a follow-up appointment in 7 to 10 days.
  • After the surgery, the patient can get exhausted quickly, but the power will eventually return. The surgery can take several weeks to completely recover.
  • For a few weeks, stop lifting something heavy. Consult the doctor to decide how much weight you can safely carry.
  • Follow the healthcare provider's guidelines for drugs, exercise, diet, and wound care.

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Frequently Asked Questions

1. Is mitral valve replacement an open-heart surgery?

Mitral valve surgery is usually performed as an open-heart procedure that requires a cut (incision) in the chest. Sometimes mitral valve surgery can be performed with minimal heart surgery and is conducted through small incisions in the chest.

2. How serious is a mitral valve replacement?

The operative risk for asymptomatic patients having mitral valve repair is around 1 in 1000. In symptomatic patients, the risk is still well below 1%. The personal risk is influenced by the involvement of coronary artery disease or other disorders that necessitate surgical intervention. Inquire with your doctor about the surgical risks you face.

3. What is the most common heart valve replacement?

The aortic valve is the most commonly replaced valve. The mitral valve is the most commonly repaired valve. The tricuspid valve and the pulmonic valve are seldom fixed or replaced.

Citations

https://en.wikipedia.org/wiki/Mitral_valve_replacement#:~:text=Mitral%20valve%20replacement%20is%20a,is%20leaky%20(mitral%20valve%20regurgitation)
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/mitral-valve-replacement-open
https://www.ncbi.nlm.nih.gov/books/NBK549879/
https://ctsurgery.weillcornell.org/surgical-services/cardiac-surgery/mitral-valve-repair-and-replacement
https://www.cedars-sinai.org/health-library/tests-and-procedures/m/mitral-valve-replacement-minimally-invasive.html