Mitral valve repair is an open-heart procedure performed by cardiothoracic surgeons to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the "inflow valve" for the left side of the heart. Blood flows from the lungs, where it picks up oxygen, and into the heart through the mitral valve. When it opens, the mitral valve allows blood to flow into the hearts main pumping chamber called the left ventricle. It then closes to keep blood from leaking back into the lungs when the ventricle contracts (squeezes) to push blood out to the body. It has two flaps, or leaflets.
Why is mitral valve repair necessary?
The mitral valve is the inflow valve into the left side of the heart. It closes during systole (when the ventricle contracts or squeezes blood out into the aorta and the rest of the body). When the mitral valve leaks, blood flows backward into the lungs. The ventricle must therefore pump more blood with each contraction to produce the same forward output of blood throughout the body. This resulting condition is called a volume overload. The heart can compensate for this volume overload for many months or years (provided the leakage came on slowly and progressively), but it eventually begins to fail producing symptoms of shortness of breath or fatigue.
When is surgery necessary?
The indications for mitral valve repair are undergoing constant re-evaluation. Recent evidence suggests that earlier surgical intervention, particularly if mitral valve repair is possible, may prevent irreversible damage to the heart. The decision regarding when to proceed with surgery should be made with your doctor. This decision will require judgment regarding the risk of surgery and the benefits available from mitral valve surgery. In some cases blood pressure medications, such as Ace Inhibitors can significantly relieve symptoms.
Mitral Valve repair versus replacement
In the past, leaking mitral valves were replaced with artificial valves. Although these artificial valves work well, they can wear out (requiring replacement surgery in 10-15 years), carry the risk of clot formation, or require the use of a blood thinner pill, coumadin, which must be taken daily. At NorthShore University HealthSystem, over 75% of mitral valves are repaired when indications are appropriate, avoiding the potential complications of valve replacement.
What to expect
The night before your mitral valve surgery, you will be allowed to eat dinner, but it is advised not to. Nothing to eat or drink after midnight except for small sips of water with medication. No aspirin products. Sleeping pills will be provided if needed. Fleets enema will be prescribed. Antibacterial soap should be used for last shower. You will be called by the ambulatory surgery unit and told what time to come to the hospital the next morning. The operating room has been specially prepared for your mitral valve surgery. The anesthesiologist will give you medication shortly before your surgery begins which will make you drowsy. After you are asleep a breathing tube will be inserted and your breathing will be taken over by a ventilator (breathing machine). After surgery you will go to the Intensive Care Unit for 24 hours. The breathing tube will be discontinued when you are fully awake. From the intensive Care Unit you will be transferred to a private room on the cardiothoracic Surgery Unit. You will be in the hospital for 4 - 5 days.
If you would like additional information on mitral valve repairs or would like to make an appointment, call 847.570.2868.
2650 Ridge Avenue
Evanston, IL 60201