What is Mitral Valve Repair and Mitral Valve Replacement? Purpose, Procedure & Results

Mitral valve repair and replacement are heart surgeries that fix problems with your mitral valve, one of four valves that control blood flow through your heart. Think of your mitral valve as a door between two rooms in your heart - it opens to let blood flow from your left atrium to your left ventricle, then closes to prevent blood from flowing backward.

When this valve doesn't work properly, your heart has to work harder to pump blood effectively. These surgical procedures can restore normal blood flow and help your heart function better, often dramatically improving your quality of life.

What is mitral valve repair and mitral valve replacement?

Mitral valve repair means your surgeon fixes your existing valve to help it work better. This might involve tightening loose valve flaps, removing extra tissue, or adding supportive structures to help the valve close properly.

Mitral valve replacement involves removing your damaged valve completely and putting in a new one. The new valve can be mechanical (made from durable materials like metal) or biological (made from animal or human tissue).

Your surgeon will typically try repair first when possible, since keeping your original valve often leads to better long-term outcomes. However, sometimes the damage is too extensive, and replacement becomes the better option for your health.

Why is mitral valve repair and replacement done?

These procedures treat mitral valve disease, which happens when your valve doesn't open wide enough or doesn't close completely. This forces your heart to work harder and can lead to serious complications over time.

Your doctor might recommend surgery if you have mitral stenosis, where the valve opening becomes too narrow and restricts blood flow. This condition often develops gradually and can make you feel tired, short of breath, or cause chest pain during daily activities.

Mitral regurgitation is another common reason for surgery, where the valve doesn't close properly and blood leaks backward. This can happen suddenly due to infection or injury, or develop slowly over years due to wear and tear.

Some people need surgery for congenital mitral valve problems they were born with. Others develop valve issues after rheumatic fever, heart attacks, or infections that damage the valve tissue.

What is the procedure for mitral valve repair and replacement?

Your surgery will happen in an operating room under general anesthesia, so you'll be completely asleep throughout the procedure. Most surgeries take between 2 to 4 hours, depending on the complexity of your specific case.

Your surgeon can access your heart through different approaches. The traditional method involves making an incision down the center of your chest and opening your breastbone to reach your heart directly.

Minimally invasive approaches use smaller incisions, often between your ribs on the right side of your chest. This approach typically means less pain and faster recovery, though not everyone is a candidate for this technique.

During the surgery, you'll be connected to a heart-lung bypass machine that temporarily takes over your heart's pumping function. This allows your surgeon to work on your still heart with precision and safety.

For repair procedures, your surgeon might reshape valve leaflets, remove excess tissue, or implant a ring around the valve to help it close better. Replacement involves carefully removing the damaged valve and sewing a new one in its place.

How to prepare for your mitral valve surgery?

Your preparation begins with comprehensive testing to ensure you're ready for surgery. This typically includes blood tests, chest X-rays, and detailed heart imaging to help your surgical team plan the best approach.

You'll meet with your surgical team beforehand to discuss the procedure, ask questions, and understand what to expect. This is also when you'll learn about anesthesia and any specific instructions for your case.

Your doctor will review all medications you're taking, as some may need to be stopped or adjusted before surgery. Blood thinners, in particular, often require careful timing to balance bleeding risk with clotting prevention.

Physical preparation usually involves stopping eating and drinking after midnight the night before surgery. You'll also shower with special antibacterial soap to reduce infection risk.

Emotional preparation is equally important. Many people find it helpful to arrange for family support, prepare their home for recovery, and discuss any concerns with their healthcare team.

How to read your mitral valve surgery results?

Your surgical success is measured by how well your heart functions after the procedure and how much your symptoms improve. Your doctor will use several tests to evaluate these outcomes over time.

Echocardiograms show how well your new or repaired valve is working by measuring blood flow and checking for leaks. These tests will happen regularly after surgery to monitor your progress.

Your symptoms provide important information about surgical success. Many people notice improved energy levels, easier breathing, and better ability to exercise within weeks to months after surgery.

Blood tests help monitor your overall heart health and, if you have a mechanical valve, ensure your blood-thinning medication is working properly. Your doctor will track these levels carefully to prevent complications.

Exercise tolerance testing might be done months after surgery to see how well your heart handles increased activity. This helps guide your return to normal activities and exercise.

How to optimize your recovery after mitral valve surgery?

Your recovery happens in phases, starting with close monitoring in the intensive care unit for the first day or two after surgery. During this time, your medical team watches your heart function and manages any immediate post-surgical needs.

Cardiac rehabilitation programs can significantly improve your recovery and long-term outcomes. These supervised programs help you gradually rebuild strength and endurance while learning heart-healthy lifestyle habits.

Following your medication schedule exactly as prescribed is crucial for success. If you have a mechanical valve, blood thinners become a lifelong necessity to prevent dangerous blood clots.

Gradual activity progression helps your body heal properly while rebuilding strength. Your doctor will provide specific guidelines about lifting restrictions, driving, and returning to work based on your individual recovery.

Regular follow-up appointments allow your medical team to monitor your progress and catch any potential issues early. These visits typically become less frequent over time as your recovery progresses.

What is the best outcome for mitral valve surgery?

The best outcome combines excellent valve function with significant improvement in your quality of life. Most people experience dramatic relief from symptoms like shortness of breath, fatigue, and chest pain.

Successful repair or replacement should restore normal blood flow through your heart, allowing it to pump more efficiently. This often means you can return to activities you may have had to limit before surgery.

Long-term success depends on several factors, including your overall health, the type of procedure you had, and how well you follow your post-surgical care plan. Repaired valves often last 15-20 years or more.

Mechanical replacement valves can last decades but require lifelong blood thinners. Biological valves may need replacement after 10-20 years but typically don't require long-term blood thinners.

The best outcomes occur when people maintain heart-healthy lifestyles, take medications as prescribed, and keep up with regular medical follow-up throughout their lives.

What are the risk factors for mitral valve surgery complications?

Age and overall health status significantly influence surgical risk, with older patients and those with multiple health conditions facing higher chances of complications. However, successful surgery is still very possible across all age groups.

Pre-existing heart conditions like severe heart failure, previous heart attacks, or other valve problems can increase surgical complexity. Your surgical team carefully evaluates these factors when planning your procedure.

Lung disease, kidney problems, or diabetes can affect healing and recovery. Your medical team will optimize management of these conditions before surgery to minimize risks.

Emergency surgery typically carries higher risks than planned procedures. This is why doctors often recommend surgery before symptoms become severe, when you're in better overall condition.

Certain anatomical factors, such as previous chest surgery or unusual heart structure, can make the procedure more challenging. Advanced imaging helps surgeons plan for these situations.

Is it better to have mitral valve repair or replacement?

Repair is generally preferred when possible because it preserves your natural valve and often provides better long-term outcomes. Repaired valves typically last longer and maintain better heart function over time.

Your surgeon's decision depends on the extent of damage to your valve and the likelihood of successful repair. Some conditions, like severe calcification or extensive tissue damage, make replacement the better choice.

Repair procedures often have lower immediate surgical risks and may require less intensive blood-thinning medication afterward. This can mean fewer medication-related complications in the long run.

However, replacement might be necessary if your valve is severely damaged or if previous repair attempts have failed. Modern replacement valves provide excellent outcomes when repair isn't possible.

Your surgeon will discuss the best option for your specific situation based on your valve condition, age, lifestyle, and overall health. The goal is always to choose the approach that gives you the best long-term outcome.

What are the possible complications of mitral valve surgery?

Like all major surgeries, mitral valve procedures carry some risks, though serious complications are relatively uncommon with experienced surgical teams. Understanding these possibilities helps you make informed decisions and recognize warning signs.

Bleeding during or after surgery can occur, sometimes requiring blood transfusions or additional procedures to control. Your surgical team monitors this closely and has protocols to manage bleeding effectively.

Infection represents another potential complication, ranging from minor wound infections to more serious conditions affecting the heart or bloodstream. Preventive antibiotics and sterile techniques significantly reduce this risk.

Stroke or other neurological complications can occur due to blood clots or changes in blood flow during surgery. Your medical team uses various strategies to minimize these risks throughout the procedure.

Heart rhythm problems sometimes develop after surgery, though these often resolve as your heart heals. Some people may need temporary or permanent pacemakers to manage rhythm issues.

Rare but serious complications include damage to surrounding heart structures, valve leakage, or the need for additional surgery. Your surgical team's experience and careful planning help minimize these risks.

When should I see a doctor about mitral valve surgery recovery?

Contact your doctor immediately if you experience chest pain that's different from your expected surgical discomfort, especially if it's severe or accompanied by shortness of breath. These symptoms could indicate complications that need urgent attention.

Signs of infection around your surgical site require prompt medical evaluation. Watch for increased redness, warmth, swelling, or drainage from incisions, especially if accompanied by fever.

Sudden shortness of breath, especially when lying flat, or swelling in your legs and feet could indicate heart function problems or fluid retention. These symptoms warrant immediate medical attention.

If you have a mechanical valve, any unusual bleeding or signs of blood clots need urgent evaluation. This includes severe headaches, vision changes, or unusual bruising.

Don't hesitate to call your medical team about any concerns during recovery. They expect questions and want to ensure your healing progresses smoothly.