Open-heart surgery is the traditional way to fix a mitral valve.
The mitral valve is a small but essential part of the heart. It lies between the two left chambers of the heart: the left atrium and left ventricle. When the valve is open, it lets blood flow from the lungs and left atrium to the left ventricle, the main pumping chamber of the heart. When the left ventricle contracts to pump blood into your body, the mitral valve closes to prevent blood from leaking backwards into your lungs. If the mitral valve is damaged or deformed, or doesn’t work correctly, it may need a repair by surgery.
Open-heart surgery is the traditional procedure for repairing the mitral valve. This involves a deep cut (incision) that goes through your breastbone. There are other less invasive valve repair options available.
When is an open mitral valve repair needed?
The most common reason for mitral valve repair surgery is to correct a leaking valve, also known as mitral regurgitation or mitral insufficiency.
This leaking can occur because of a congenital heart defect (something someone is born with), damage from a heart attack, advanced age or a bacterial infection in the valve.
Sometimes a mitral valve needs to be repaired because it’s too stiff to open correctly (mitral stenosis). This can be congenital, meaning someone is born with this condition. It can also be caused by damage from rheumatic fever.
In general, the results are better when a surgeon repairs, rather than replaces, a mitral valve. But if a valve has too much damage, the surgeon may need to replace it. Your health care provider will perform tests before surgery to evaluate which treatment is best for you.
Before open mitral valve repair
Before mitral valve repair surgery, your medical team will determine the repairs that you’ll likely need. You’ll probably have a transesophageal echocardiogram (TEE). This is an imaging test done through the esophagus to let the surgeon get a better look at your mitral valve.
The surgeon will explain the procedure. Use this time to ask questions.
In addition to a complete health history, the medical team may request a complete physical exam to ensure you are in good health before undergoing surgery. You may have blood tests, including one that checks how long it takes your blood to clot, or other diagnostic tests.
If you smoke, you should stop smoking as soon as possible before the surgery. This can improve your chances for a successful recovery from surgery and benefit your overall health.
After open mitral valve repair
Recovery can feel slow. It may be four to six weeks or longer before you start feeling better.
Everyone’s situation is different, but the outlook after mitral valve repair is often very good. The outlook may be less positive if your surgeon used more complex methods to fix your mitral valve, or if rheumatic fever damaged your mitral valve.
If you need dental work in the future, your doctor may give you antibiotics to prevent infection of your mitral valve. Before you have any dental procedure, always tell your dentist you’ve had valve surgery.
Your provider may suggest that you begin a cardiac rehabilitation program. This program gradually reintroduces you to a normal lifestyle. Cardiac rehabilitation begins in the hospital with simple walking and progresses to a regular exercise routine and a nutritious diet. Committing to healthier habits can prevent future heart problems.
Vanderbilt University Medical Center is a leader in treating heart valve disease with the newest transcatheter techniques. Vanderbilt’s team includes general cardiologists, interventional cardiologists and cardiac surgeons, all with advanced training and expertise in structural heart and valve disease. They treat patients with diseases of the aortic, mitral or tricuspid valve, from the routine to the complex.
