Mitral valve surgery is a heart operation that treats the valve between the left atrium and left ventricle when it leaks or has become narrowed. The surgeon either repairs the patient's own valve or replaces it with a prosthetic one. The aim is to restore normal blood flow and ease symptoms such as breathlessness and fatigue.
The operation is done under general anaesthesia, usually through an incision over the breastbone and sometimes through smaller cuts, while a heart-lung machine takes over the work of the heart. In a repair, the surgeon reshapes the leaflets and supporting cords and may add a ring to hold the valve in shape. In a replacement, the damaged valve is removed and a mechanical or biological valve is sewn in.
Surgery commonly takes three to five hours, followed by a day or two in intensive care and roughly five to ten days in hospital. A mechanical valve requires lifelong blood-thinning treatment. Full recovery usually takes about six to twelve weeks, depending on the individual.
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It improves blood flow within the heart and may relieve symptoms such as breathlessness, palpitations and tiredness. It can also limit further strain on the heart muscle caused by a faulty valve. Benefit varies between patients, and no particular result can be guaranteed.
It is usually considered for people with severe leakage or narrowing, clear symptoms, or test findings showing that the heart is starting to be affected. The heart team decides the timing and type of surgery after an echocardiogram and other tests.
Repair keeps the patient's own valve and corrects its defect, and it often reduces the need for blood thinners. Replacement is used when the valve is badly damaged, with either a mechanical valve that lasts a long time but needs lifelong blood thinners, or a biological valve that may need replacing later.
Preparation usually includes blood tests, an echocardiogram, a chest X-ray and sometimes a diagnostic catheter test. Your doctor will advise you about your medicines and fasting, and any infection, including dental infection, should be treated beforehand.
After general anaesthesia, the surgeon reaches the heart through the breastbone or a smaller incision, and a heart-lung machine supports the circulation. The valve is then repaired or replaced, the chest is closed and temporary drains are placed.
Patients spend several days in hospital and start gentle movement early. Heavy lifting is generally avoided for about six to eight weeks, and a cardiac rehabilitation programme may be recommended. The full recovery time depends on each patient.
A successful repair may last many years, and a mechanical valve usually lasts for decades, while a biological valve varies. No duration is guaranteed, so regular follow-up with echocardiography is essential.
They include bleeding, infection, heart rhythm disturbances, blood clots or stroke, and kidney or lung problems, and some patients need further surgery. Anaesthesia and the heart-lung machine carry their own risks, which your surgeon will discuss with you beforehand.
With a mechanical valve, a blood thinner such as warfarin is needed for life, with regular blood tests. After a repair or a biological valve, it may be prescribed for a limited time only, as your doctor decides.
You will usually need to stay at least two to three weeks after surgery. The treating doctor confirms the travel date after a check-up and an echocardiogram.
