Mitral valve surgery - open

Definition

Mitral valve surgery is used to repair or replace the mitral valve in your heart.

Blood flows between the different chambers in the heart through valves that connect the chambers. One of these is the mitral valve. The mitral valve opens so blood can flow from the left atrium to the left ventricle. The valve then closes, keeping blood from flowing backward.

In this type of surgery, the surgeon makes a large cut in your breastbone to reach the heart. Other types of surgery use several smaller cuts.

Alternative Names

Mitral valve replacement - open; Mitral valve repair - open; Mitral valvuloplasty

Description

Before your surgery, you will receive general anesthesia. You will be asleep and pain-free during the procedure.

If your surgeon can repair your mitral valve, you may have:

If your mitral valve is too damaged to be repaired, you will need a new valve. This is called replacement surgery. Your surgeon will remove your mitral valve and sew a new one into place. There are two types of mitral valves:

Once the new or repaired valve is working, your surgeon will:

You may have a temporary pacemaker connected to your heart until your natural heart rhythm returns.

This surgery may take 3 to 6 hours.

Why the Procedure Is Performed

You may need surgery if your mitral valve does not work properly.

You may need open-heart valve surgery for these reasons:

Risks

Risks for any surgery are:

Possible risks from having open-heart surgery are:

Before the Procedure

Always tell your health care provider:

You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your provider if you and your family members can donate blood.

You may need to stop taking medicines that make it harder for your blood to clot for 2 weeks before the surgery. These might cause increased bleeding during the surgery.

Get your house ready before you go to the hospital so things will be easier when you return.

The day before your surgery, take a shower and wash your hair. You may need to wash your whole body below your neck with a special soap. Scrub your chest 2 or 3 times with this soap. You also may need to take an antibiotic to guard against infection.

During the days before your surgery:

On the day of the surgery:

After the Procedure

Most people spend 4 to 7 days in the hospital after surgery.

You will wake up in the intensive care unit (ICU). You will recover there for 1 to 2 days. You will have 2 to 3 tubes in your chest to drain fluid from around your heart. The tubes are most often removed 1 to 3 days after surgery.

You may have a flexible tube (catheter) in your bladder to drain urine. You may also have intravenous (IV) lines to get fluids. Monitors that show vital signs (pulse, temperature, and breathing) will be watched carefully.

You will be moved to a regular hospital room from the ICU. Your heart and vital signs will be monitored until you go home. You will receive pain medicine to control pain around your surgical cut.

Your nurse will help you begin activity slowly. You may go to a physical therapy program to make your heart and body stronger.

Outlook (Prognosis)

Mechanical heart valves last a lifetime. However, blood clots may develop on them. This can cause them to become infected or clogged. If a blood clot forms, you may have a stroke.

Valves made from human or animal tissue fail over time. They have an average lifespan of 10 to 20 years before needing to be replaced. They have a lower risk of blood clots.

References

Otto CM, Bonow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 63.

Rosengart TK, Anand J. Acquired heart disease: valvular. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 60.


Review Date: 1/31/2017
Reviewed By: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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