Mitral Valve Surgery

Background

The mitral valve controls blood flow between the atrium and the ventricle on the left side of the heart, which pumps oxygenated blood to the body. There are two main problems that can occur with the mitral valve: it can become too narrow (stenosis), or it can leak (regurgitation). Abnormal blood flow through this valve causes the heart to work harder and eventually can lead to heart failure. Symptoms of this include shortness of breath, light-headedness, fatigue, chest pain or palpitations.

About the surgery

Depending on the type of mitral valve disease, the valve can either be repaired or replaced with an artificial prosthesis.

Repair is preferred over replacement since it provides better long-term survival, better preservation of heart function, lower risk of complications, and eliminates the need for long-term use of blood thinners (anticoagulants). Repair can be performed in most patients with regurgitant mitral valves, and some with stenotic mitral valves. There are a number of ways of repairing the mitral valve, and some examples include sewing a ring around the outside of the valve (called ring annuloplasty), removing some of the leaky parts of the valve leaflets (called resection), or replacing some of the cords that connect to the valve (called neo-chordae).

If the mitral valve does need to be replaced, then there are two types of artificial valves: biological (tissue) valves (commonly made out of pig tissue (porcine) or cow tissue (bovine)), and mechanical valves (made out of carbon fibre). Choosing whether to have a mechanical or tissue valve is a complex decision that every patient must make, and so the differences should be discussed with their surgeon. See our page on "Mechanical or Tissue Valve?"

Recovery period

Patients usually stay in the intensive care unit for one to two days for monitoring and then move to the ward for four to five days. Two to three tubes stay in the chest to drain fluid from around the heart and are usually removed one to three days after the surgery. Full recovery usually takes about two months. Most patients are able to drive in about four to six weeks after surgery. Your surgeon will provide specific guidelines for your recovery and return to work.

Risks of the surgery

As with all surgery, mitral valve repair and replacement are associated with some risks. Your surgeon will calculate these risks specific to you, and discuss them with you.

All patients should consult their cardiothoracic surgeon for specific information about their medical condition and surgery.