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The mitral valve is on the left side of the heart. It allows blood to flow from the left upper chamber into the left lower chamber. When the valve is not working well, it may need to be replaced.
Healthy heart valves allow blood to flow one way. Diseased valves either
leak and cause back flow or narrow and restrict flow. The condition can
be life threatening. Sometimes the valve can be repaired. Other times,
it must be replaced.
Rheumatic fever, infections, defects at birth, and wear and tear are the most common causes of mitral valve problems.
If you are planning to have a mitral valve replacement, your doctor will review a list of possible complications, which may include:
The demands of open-heart surgery are severe. The better your general health, the less likely you will experience a complication. Some of the risk factors that must be evaluated before you undergo this procedure include:
Your doctor will evaluate both your general health and the condition of your heart and circulation. Expect several heart tests, including an electrocardiogram (EKG) and an echocardiogram using ultrasound. Some patients may also have cardiac catheterization.
Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as:
Your doctor may also ask you to:
General anesthesia will be given. You will be asleep during the procedure.
An incision will be made along the length of your breast bone. The breast bone will be split lengthwise to expose your heart. You will then be put on a heart-lung machine. This machine takes over the work of your heart so that the doctor can stop your heart. Your heart will be opened. A substitute valve will be sewn into place. This valve may be mechanical (metal and plastic), such as a St. Jude valve, or it may be made of tissue. Tissue valves most often come from a pig or a cow. Tissue valves may also be supplied by a human donor or even manufactured from your own tissues. When the valve is in place, you will be taken off the heart-lung machine and your heart will be re-started. The incision will be closed.
Newer techniques, including robot-assisted procedures, are being developed. These procedures will be able to do the same surgery with smaller incisions.
You will be taken to a recovery room. You will be monitored for any negative reactions.
How Long Will It Take?
About 2-5 hours
How Much Will It Hurt?
Anesthesia will block pain during the surgery. Your chest and back will be sore following the surgery. Talk to your doctor about medicine to help manage pain.
Average Hospital Stay
The usual length of stay is 8-10 days. Your doctor may choose to keep you longer if complications arise.
At the Hospital
You will probably spend 1-3 days in the intensive care unit (ICU) and several more days in a regular hospital room. During this time, your care team will:
Be sure to follow your doctor's instructions, which may include:
Mechanical valves can last a lifetime. Tissue valves last 7-14 years and then must be replaced. If your valve is repaired and you have no complications, you will likely do well and be able to return to normal activities.
Call Your Doctor
In case of an emergency, call for medical help right away.
American Heart Association http://www.heart.org
The Society of Thoracic Surgeons http://www.sts.org
Health Canada http://www.hc-sc.gc.ca
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca
Mitral valve disease: stenosis and regurgitation. Cleveland Clinic
website. Available at:
Accessed May 16, 2013.
Mitral valve repair. Society of Thoracic Surgeons website. Available at: http://www.sts.org/doc/4107. Accessed May 16, 2013.
6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Reviewer: Ganson Purcell Jr., MD, FACOG, FACPE ; Michael Woods, MD
Review Date: 05/2013
Update Date: 03/18/2013
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.
Copyright © 2013 EBSCO Publishing
All rights reserved.
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