Mitral heart valve replacement: What to expect before and after the surgery

The mitral valve is located on the left side of the heart, between the left atrium and left ventricle. It has a very important role to play in the circulation. It is one of the four valves in the heart, that ensures that the blood flows throw the heart in the right direction and that the organs receive oxygenated blood from the heart. Oxygen-rich blood flows into the left atrium from the pulmonary veins. When the left atrium fills with blood, the mitral valve opens to allow blood to flow to the left ventricle.

Thus, the malfunctioning of the mitral valve can have serious consequences.

Purpose of the mitral heart valve replacement:

Mitral valve replacement is a procedure whereby the diseased mitral valve of a patient's heart is replaced by either a mechanical or tissue (bioprosthetic) valve.

The mitral valve may need to be replaced because:

• The valve is leaky (mitral valve regurgitation)
• The valve is narrowed and doesn't open properly (mitral valve stenosis).

Mitral valve disease is usually caused due to infection, calcification and inherited collagen disease. Current mitral valve replacement approaches include open-heart surgery.

Open Heart Surgery:

What to expect before open-heart surgery?

There are two kinds of valves, which can be used as replacement-biological and mechanical. The doctor decides which is the best for the patient.

• Biological valves are made mainly from pig, cow, or human heart tissue. Biological valves don’t last as long.
• Mechanical valves are man-made. However, if one gets a man-made valve, he/she has to take blood-thinning meds for the rest of their lives.

The following precautions need to be taken before the surgery.

• Avoiding to eat or drink anything since midnight before the surgery.
• Avoiding smoking
• Certain medications need to be stopped.

Certain routine tests are done, and about an hour before the surgery, certain medications are given which helps the patient to relax.

What to expect during the surgery?

Anesthesia is given before the surgery starts. The surgery takes several hours to complete. As the surgical procedure is an open surgery, the doctor makes an incision down the chest to access the heart. The patient is then supported using an artificial heart-lung machine during the entire course of the surgery. Then the defective valve is removed, as is replaced by the new valve.

What to expect after the surgery?

Recovery happens in the ICU or recovery room. Most people who have mitral valve replacement notice immediate symptom relief after their surgery. Doctors check for heart rate, and other vital signs. The patient is kept under intensive care. Usually, a breathing tube is kept for proper breathing, but it is removed within 24 hours. There is also a drainage pipe to remove any excess fluid which may have accumulated in the chest in the course of the surgery. The patient is usually kept in the hospital for around 5 days.

Even after getting back home from the hospital, care has to be taken. The stitches are removed in around 7-10 days during the follow-up appointments. Temperature is to be checked daily, and a temp. higher than normal should be immediately reported. Heavy exercises or strenuous jobs should be avoided for several weeks.