There are four valves in the heart. The mitral valve is one of the main valves on the left side of the heart between the left atrium and left ventricle.
It has two cusps (leaflets) that open to allow blood flow from your left atrium to your left ventricle.
The leaflets close preventing blood from flowing backward into the left atrium and into your lungs.
A mitral valve repair is the optimal surgical treatment for mitral valve disease instead of a replacement.
A repair helps preserve your own heart's shape and function. It also allows for a better survival rate from surgery with a 1-2 percent mortality rate. Another advantage to a repair is freedom from lifelong anticoagulants or blood thinners. If you have a mechanical mitral valve replacement, you may have to stay on blood thinners for the rest of your life. If you have a repair, you would only have to take a low-dose aspirin.
What are signs and symptoms of mitral valve disease?
The most common symptoms of mitral valve disease are shortness of breath while physically active or while lying flat. You may also notice increased fatigue, swollen ankles or feet, heart palpitations, or chest discomfort. Some patients may have no symptoms at all.
Your health care provider may hear a heart murmur when listening to your chest during a physical exam. Your physician may recommend a heart ultrasound (an echocardiogram). This test will determine if you have a leaky or stenotic mitral valve, and how significant it is.
What is the recovery timeline for mitral valve surgery?
The length of stay in the hospital after mitral valve surgery is about 4-5 days. After your operation, you will stay in the cardiac surgery intensive care unit for at least 24 hours. Once you are more stabilized and the breathing tube is out, you will be transferred to the cardiac surgery step down telemetry unit. You will stay there until discharge to your home or to rehab.
You may not drive for about four weeks after your surgery. After four weeks, you will be seen in a follow-up appointment with your surgeon and/or nurse practitioner and if your recovery is on track you will be cleared to drive. You may not lift anything over 10 pounds for 10-12 weeks from the date of surgery.
Will I be able to resume normal physical activities after my surgery?
Yes! You can resume a normal lifestyle after recovery form mitral valve surgery. Once you are beyond 10-12 weeks from surgery, you can push, pull, and lift over 10 pounds and resume regular physical activities.
One of the main reasons we do mitral valve surgery is to improve your quality of life. You should breathe better and have less fatigue after recovering from surgery.
Transcatheter mitral valve repair, or MitraClip, is a less-invasive treatment for patients with mitral regurgitation. It is a procedure that may be an option for patients who are not candidates for traditional mitral valve surgery. These patients are considered at high risk for open heart surgery.
The surgeon uses a catheter containing a clip and inserts this through your femoral vein. Under fluoroscopy, the surgeon guides this device to your heart. The clip is then positioned at the mitral valve and under the leaflets. The surgeon fastens the clip to the leaflets, decreasing the amount of regurgitant blood flow from the mitral valve.
What are the differences between a mechanical valve replacement and a bioprosthetic valve replacement?
Sometimes your mitral valve cannot be repaired and will need a replacement. There are two different options for a replacement:
Mechanical replacement: This uses a metal valve that lasts a lifetime but you would need to be on a certain blood thinner (warfarin) for the rest of your life. This medication requires frequent blood draws and monitoring to make sure your blood is not too thin or too thick.
Bioprosthetic valve or tissue valve: These valves are either bovine (cow) or porcine (pig). They do not require lifelong blood thinners. The disadvantage to these valves is that they gradually wear out over time. They last an average of 10-15 years in the mitral position. You will need close follow-up with your cardiologist. When the valve no longer functions as it should, your cardiologist may refer you back to the surgeon to consider a re-operation of your mitral valve.
