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Mitral Valve Replacement

Authors:
  • Ricker Polsdorfer, MD
Publication Type:

Procedure

Mitral Valve Replacement

Definition

The mitral valve is on the left side of the heart. It lets blood flow from the left upper chamber into the left lower chamber. When the valve is not working well, it may need to be replaced.

Reasons for Procedure

Healthy heart valves let blood flow one way. Damaged valves either leak and cause back flow or narrow and restrict blood flow. The condition can be life threatening. Sometimes the valve can be repaired. Other times, it must be replaced. The most common causes of mitral valve problems are:
  • Rheumatic fever and other infections
  • Problems that were there at birth
  • Wear and tear

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over problems that could happen, such as:

  • Bleeding
  • Infection
  • Harm to the heart or other organs
  • Reaction to anesthesia

Things that may raise the risk of problems include:

  • Smoking
  • Drinking alcohol
  • Chronic health issues such as diabetes or obesity

What to Expect

Problems To Look Out For

Call your doctor if you have:

  • Signs of infection, such as fever or chills
  • Redness, swelling, more pain, a lot of bleeding, or any discharge from the incision site
  • Constipation, diarrhea, bloody or tarry-color bowel movements, or stomach pain
  • Gained more than 2 pounds in 2 days
  • Severe headache
  • Nausea or vomiting
  • Cough, shortness of breath, chest pain, or coughing up blood
  • Skin rash or odd bruising or bleeding
  • Confusion
  • Lightheadedness when standing
  • Tingling in hands and feet
  • Irregular heartbeat, very slow pulse, or fast pulse
  • Redness, swelling, or pain in 1 or both legs, or ankle swelling that gets worse
  • Burning feeling while urinating (peeing)

If you think you have an emergency, call for medical help right away.

Prior to Procedure

Your doctor will check your health, heart, and blood flow. Some tests may include:

Talk to your doctor about medicines, herbs, or supplements you are taking. You may be asked to stop taking some medicine up to 1 week before the procedure.

Do not eat or drink anything the night before your procedure.

Prior to Procedure

Your doctor will check your health, heart, and blood flow. Some tests may include:

Talk to your doctor about medicines, herbs, or supplements you are taking. You may be asked to stop taking some medicine up to 1 week before the procedure.

Do not eat or drink anything the night before your procedure.

Anesthesia

General anesthesia is given before surgery. You will be asleep.

Description of the Procedure

An incision will be made along the length of the breast bone. The breast bone will be split to expose the heart. You will then be put on a heart-lung machine. This machine does the work of your heart and lungs so the doctor can stop your heart.

Your heart will be opened. A new valve will be sewn into place. This valve may be made of metal and plastic. It may be made of tissue that comes from a pig, cow, or human donor. Valves can also be made from your own tissues. When the valve is in place, you will be taken off the heart-lung machine. Your heart will be restarted and checked to make sure the valve is working. The incision in the heart will be closed. The breastbone will be closed and then the incision will be closed.

Mitral Valve Replacement.

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Newer techniques, including robot-assisted procedures, are being developed. These will be able to do the same surgery with smaller incisions.

Immediately After Procedure

You will be taken to a recovery room. Your blood pressure, pulse, and breathing will be watched.

How Long Will It Take?

About 2 to 5 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be eased with medicine.

Average Hospital Stay

The usual length of stay is 8 to 10 days. You may have to stay longer if there are problems.

Postoperative Care

At the Hospital

You will probably spend 1 to 3 days in the intensive care unit (ICU) before moving to a regular hospital room. During this time, your care team will:

  • Watch you for any problems
  • Stabilize your heart function
  • Tell you what to do once you are home

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

You can also take steps to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding your care team to wear gloves or masks
  • Not letting others touch your incisions

At Home

Once you get home:

  • Take prescription medicine such as blood thinners or antibiotics if they are prescribed by your doctor.
  • Antibiotics may be needed before dental procedures and during certain other procedures. This will help prevent a valve infection. Talk to your doctor before having dental work or other procedures done. Be sure to tell any doctors caring for you about the heart valve.
  • You will slowly return to your usual activities over a 4 to 12 week period. You may also be asked to be in a cardiac rehabilitation program.

Mechanical valves can last a lifetime. Tissue valves last 7 to 14 years and then must be replaced. If your valve is repaired and you have no problems, you will likely do well and be able to return to normal activities.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Heart valve surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17089-heart-valve-surgery.
  • Mitral valve disease. Society of Thoracic Surgeons website. Available at: https://ctsurgerypatients.org/adult-heart-disease/mitral-valve-disease.
  • Prosthetic heart valves. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/prosthetic-heart-valves.

Contributors

  • Michael J. Fucci, DO, FACC
Last Updated:
2022-11-01

(C) Copyright 2023 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.