Minimally Invasive Mitral Valve Repair and Replacement
Located between the heart’s upper and lower left chambers, the mitral valve is one of four heart valves that control blood flow from the heart to the rest of the body. If you have severe mitral valve disease, your heart doctor may recommend minimally invasive mitral valve repair and replacement.
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Find a Heart Valve DoctorWho Might Need Minimally Invasive Mitral Valve Repair or Replacement?
Minimally invasive heart surgery uses small incisions to repair or replace a mitral valve, rather than open heart surgery. The benefits include a shorter hospital stay, quicker recovery and less post-surgical pain. The heart’s mitral valve may need to be repaired or replaced if you have either of the following conditions:
- Mitral valve regurgitation: The mitral valve’s flaps (leaflets) don’t close tightly, causing blood to leak backward through the valve. Mitral valve repair surgery is often recommended for people with moderate to severe mitral valve regurgitation symptoms.
- Mitral valve stenosis: The mitral valve opening narrows, resulting in decreased blood flow from the left atrium to the left ventricle. The narrowing happens because the valve’s leaflets have grown abnormally stiff or thick. Mitral valve surgery may be recommended if the stenosis is severe and causes shortness of breath or other symptoms.
Both mitral valve regurgitation and mitral valve stenosis can cause symptoms including severe fatigue, shortness of breath, fluid buildup in the legs (edema), fluid buildup in the lungs (pulmonary edema) and heart palpitations. When symptoms are severe or the valve is significantly damaged, you may need valve repair or replacement.
Risks & Complications
Minimally invasive heart surgery techniques have fewer risks than open surgery. Potential risks include:
- Infection of the new valve
- Irregular heartbeat that must be treated with medicines or a pacemaker
- Kidney failure
- Poor healing of surgical wounds
- Blood clots leading to stroke or heart attack
- Inability to complete the procedure, resulting in open heart surgery
- Damage to other organs, nerves or bones
Benefits
The benefits of minimally invasive surgery include:
- Faster healing and recovery
- Less pain and reduced need for opioids
- Lower risk of infection and blood loss
- Less scarring
- Shorter hospital stays
- Less post-surgical pain
What to Expect
- Before
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You will receive general anesthesia to put you in a sleep-like state during the surgery. You are connected to a heart-lung bypass machine, which takes over the work of your heart and lungs during your surgery.
- During
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In both open mitral valve repair and replacement surgery, your surgeon will access the heart through a few small incisions in the chest.
If the mitral valve is repairable, you may have a:
- Ring annuloplasty: The surgeon reinforces the natural ring (annulus) that surrounds the mitral valve by sewing a ring of metal, cloth or tissue around it.
- Valve repair: The surgeon rebuilds one or both of the flaps that open and close the mitral valve.
If the mitral valve is too damaged for a repair, it will be replaced. In this procedure, your surgeon removes some or all of the mitral valve and replaces it with a new one. There are two types of replacement valves:
- Mechanical: These valves are made from materials such as titanium and carbon. Mechanical valves last the longest, but you’ll need to take a blood-thinning medicine for the rest of your life if you get one.
- Biological: Biological valves are made from human or animal tissue. They last 10 to 15 years or longer, and usually do not require you to take blood thinners for the rest of your life.
- After
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After minimally invasive mitral valve repair and replacement surgery, you can expect to:
- Spend one or two days in the ICU, where you’re closely monitored, checking your pulse, breathing and other vital signs.
- Spend several more days recovering in a hospital room.
- Receive medication for arrhythmia (irregular heartbeat) if you had valve replacement surgery. Arrhythmias are common after valve replacement. You may also temporarily need a pacemaker to correct an arrhythmia.
- If you had valve replacement surgery, you will begin anticoagulation therapy to reduce the risk of getting a blood clot. If you received a biological valve, you’ll likely need to take anticoagulation medication for up to three months. If you received a mechanical valve, you’ll need to take anticoagulation medication for life.
- With the help of your care team, slowly increase your activity, take progressively longer walks and do breathing exercises.
- Learn about cardiac rehab, which can aid recovery from both mitral valve repair or replacement surgery.
- Learn how to care for your incision at home.
- Receive instructions on what medicines you need to take and when, how to manage pain and other side effects, and how to identify symptoms of infection and when to call your care team.
Recovery
You may feel more fatigued than usual for the first few weeks following surgery. Avoid heavy lifting for several weeks. Your care team will also give you instructions about when you can go back to work and resume other activities.
Regular follow-ups will make sure your new or repaired valve is working properly. Your doctors may also recommend cardiac rehabilitation, which can help you safely increase your activity levels and healthy lifestyle habits, including diet and exercise.
Why Choose UH Harrington Heart & Vascular Institute?
UH Harrington Heart & Vascular Institute serves Northeast Ohio communities and beyond with award-winning heart and vascular expertise. We’re recognized as a best-in-class choice by patients and healthcare providers. Our heart and vascular specialists consistently earn high ratings on HCAHPS patient experience surveys and provider review sites like Healthgrades and RateMDs. In addition to clinical practice, our physicians are advancing the field of cardiovascular medicine and surgery by leading nationally funded clinical trials.