Mitral valve repair is kind of surgical procedure in which the mitral valve is replaced or repaired. Normally blood travels from the lungs to the heart, moving onto the first chamber of the heart, known as the “left atrium”. Then, the blood runs into the left ventricle. The mitral valve normally opens from the left atrium to the left ventricle. It prevents blood from backing up into the left atrium.
Mitral valve surgery may be necessary if the mitral valve is too loose, causing blood to flow back from the left ventricle into the left atrium. It may also be necessary if the mitral valve is too narrowed, causing it to be difficult to pass blood from the left atrium into the left ventricle.
Mitral valve surgery can be done in two ways: It can be done as an open surgery (in which the entire chest is opened so the heart can be visualized). It can also be done as a minimally invasive surgery (in which the surgeon uses many small cuts in the skin and the chest isn’t exposed).
When it comes to minimally invasive mitral valve surgery, there are many ways to do it. The cardiac surgeon may make a 2-3-inch-long incision in the right side of the chest near the breastbone. Muscles in this area are split into two pieces. This allows the cardiac surgeon to gain access to the heart. Another small incision is made in the left side of the heart so the operating surgeon can replace or repair the mitral valve.
In endoscopic surgery, the cardiac surgeon will make 1-4 tiny holes in the chest. The surgeon uses a tube that has a light and a camera attached to the end of it so the surgeon can see inside the heart. Special tools are also attached to the end of the tube so that the doctor can make changes in the mitral valve. Each incision is one-half to three-fourths inch long. The mitral valve is shown on a video monitor in the surgical suite.
The patient will need to be on a heart-lung machine during the surgery. Small incisions are made in the patient’s groin in order to hook up the patient’s circulation with the heart-lung machine. The two types of surgery done on patients with mitral valve problems are a valve repair (when the heart surgeon rebuilds, shapes, trims the flaps of the valve) and ring annuloplasty (when heart surgeon constricts the mitral valve by sewing a metal, tissue, or cloth ring around the valve).
In some cases, the mitral valve will need to be replaced. The valve can be replaced with a biological valve (made from animal or human hearts) and a mechanical valve (made from artificial materials, such as carbon of titanium). The mechanical valves last longer than the biological valve, which only last between ten and fifteen years. The surgery takes about 2-4 hours.
Sometimes, the surgery can be done via an artery in the area of the groin. No incisions are made with this type of surgery. The surgeon directs a catheter with a balloon connected to the end of it. The balloon is used to increase the opening of the mitral valve. This called a percutaneous valvuloplasty.
Right after the surgery, the patient will be taken to the ICU (intensive care unit). After 4-5 hours, the ventilation tube can be removed and the patient will be able to breathe on their own. The patient remains in the ICU at least one night while the patient’s vital signs and heart rhythm will be evaluated.
For the first 3 months after mitral valve surgery, the patient will take some kind of blood thinner, such as warfarin. This lessens the chance that the patient will have an embolic stroke from blood clots forming on the mitral valve. After the patient goes home, they will be able to ambulate normally and should try to walk at least one mile daily in the first month after surgery.
If the patient has had any type of valvular disease, such as mitral valve stenosis, mitral valve regurgitation, or mitral valve replacement, they need to tell their dentist or doctor that they have the condition as antibiotic prophylaxis may need to be necessary.
Follow-up occurs after the patient has had mitral valve repair. The patient needs to see the surgeon a month after the operation. During these visits, the cardiac surgeon will evaluate the function of the mitral valve and will makes sure the patient’s vital signs remain normal.
In preparing to have mitral valve repair, the patient often has many questions. They want to know how much the surgery costs and what to do to help the recovery move along faster. They want to know if there is any pain associated with the recovery process.
The cost of mitral valve surgery varies from surgeon to surgeon, and from state to state. The best way to prepare for surgery is to get estimates from various cardiac surgeons so the patient can get a cost effective surgery. The surgeon should be chosen, and the insurance company needs to be contacted. If the patient has Medicaid or Medicare, they need to be contacted as well.
The patient needs to follow the surgeon’s preoperative directions. The patient should take a look at the surgeon’s instructions several times before surgery. Pain medication may be prescribed by the physician for any pain the patient may have after surgery. The patient should eat as healthy as possible prior to mitral valve repair. It helps in the recovery process.
The patient should try to make meals before surgery so that they can be frozen for use after the surgery is over and after the patient returns home. The home environment may need to be modified in order to keep the environment as safe as possible for the patient. All medications should be looked over by the surgeon in order to decide whether or not a certain medication may need to be stopped or taken with a sip of water the morning of the procedure.
The patient may need to have mitral valve repair in cases of mitral valve regurgitation (leakage of the valve) and mitral valve stenosis (narrowing of the mitral valve). Patients with mitral valve prolapse that can’t be managed with medication may also need to have mitral valve repair. Any time the patient has severe symptoms of mitral valve disease that don’t respond to medications, mitral valve repair may be necessary.
The patient needs both rest and some increase in activity after surgery. Physical therapy may need to be performed in order to teach the patient ways to recover from surgery in the safest possible way. The nurse will help the patient first sit on the bed before ambulating. After that, physical therapy takes over for the cardiac rehabilitation process. The patient may take medications after surgery as well. Blood thinning medications are often recommended in order to prevent blood clots from forming on the repaired (or replaced) mitral valve.
Coronary valve repair or replacement procedure is an important surgery after which the patient will often restore his health after as a result of the installation of a new valve at a sensitive location inside the heart.
The mitral valve is one of the four most important valves in the heart chambers. It is located between the left atrium and the left ventricle, regulating the passage of blood pumped by the left atrium to the left ventricle after receiving blood from the lungs. The mitral valve may have a defect that either causes the blood to leak in the opposite direction to the left atrium as a result of its expansion or stenosis, which normally impedes blood flow to the left ventricle, requiring an operation to repair or change the mitral valve.
Coronary valve surgery may be performed in two ways, either by open heart surgery or through minimal invasive surgery (catheterization) through very small incisions. Coronary valve repair by catheterization is a common method in valvar surgeries due to its multiple advantages to the patient.
Treatment takes approximately "8 days".
A cardiovascular surgeon can decide to repair or replace a patient's mitral valve because of one of the following:
After a mitral valve repair or replacement surgery is scheduled, the patient undergoes a series of tests to check his health ability for the surgery. These tests include:
Despite the good success rates of the mitral valve repair/replacement surgery, it is like other surgeries, may have some complications that the patient may experience, including:
This surgery consists of three main stages:
Once the mitral valve repair/replacement surgery is approved, the patient is prepared by the assistant medical team, but before that, he must go to the hospital to confirm check-in date and complete the procedures, the doctor sits with the patient before starting the surgery preparations and discusses with him all the reasons for surgery and the patient is informed of all the risks clearly and explicitly, the patient agrees to the surgery and the risks involved by signing the consent form.
The cardiac surgeon asks the patient to stop taking certain medications, and to refrain from smoking for a while before the surgery, also it is important to tell about any drugs allergies.
It can be done in two ways:
If the mitral valve is repaired, the cardiac surgeon will either reinforce the valve with a ring around the valve to tighten it or by re-shape of the valve itself by removing excess tissues.
If the mitral valve is replaced, the old damaged valve is removed and replaced by another valve, either mechanical (titanium or carbon) or biological (from human or animal tissues such as cows).
In such type of surgeries heart-lung machine is often used.
Mitral valve replacement or repair takes approximately 2 to 4 hours.
The patient is transferred to the intensive care unit immediately after the surgery and stays for a day or more depending on his condition; to monitor vital functions such as blood pressure, breathing, heart rate and reassure his health in general, then he is moved to a regular room inside the hospital with continued monitoring and medical supervision of his health. The patient's stay in the hospital after coronary valve repair or replacement surgery for 3 to 5 days, depending on his health and the type of surgery performed.
After leaving the hospital, the patient must abide by the instructions given by the cardiac surgeon to stay healthy from any complications and to return to normal activities faster, as it is often advised to take a range of medications for a certain period determined by the surgeon, in addition to the need to follow other instructions about the new lifestyle through exercise, healthy diet, the need to refrain from smoking and other important tips.
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