Talking With Your Doctor About Mitral Valve Surgery
The mitral valve regulates blood flow between the upper and lower chambers on the left side of your heart. If it’s not working correctly, your cardiologist may suggest surgery to repair or replace it.
Mitral valve disease can cause the walls of your heart to stretch and weaken; so your heart has to work harder to pump blood. The valve may be “prolapsed,” which means the flaps don’t close tightly and blood can leak or, less often, the valve can become stiff and narrow, sometimes as the result of rheumatic fever.
You may not have any symptoms in early stages of mitral valve disease, and your doctor may be able to treat you with medication. Over time, you can develop symptoms including a cough, fatigue or chest pain. Mitral valve disease can lead to irregular heart rhythms (atrial fibrillation, or afib), blood clots, heart failure, stroke, or other serious health conditions.
If your doctor recommends surgery, ask about the type of mitral valve procedure he or she is recommending and why, the risks of the surgery, and how it can improve your health and well-being.
Types of Mitral Valve Surgery
Ask about your surgeon’s experience performing mitral valve surgery and why he or she is recommending you undergo it now. Even if you are not symptomatic, doctors may suggest mitral valve surgery to prevent complications before they arise, and there is evidence that having the surgery earlier in the disease leads to better results.
If you need an operation for another heart condition, your doctor may want to repair or replace the diseased mitral valve at the same time. There are two main surgical approaches to mitral valve disease you can discuss with your physician:
Mitral Valve Repair
In many people, the defective mitral valve can be repaired. Your surgeon can patch holes in the valve, reconnect or separate the flaps as needed, replace the tissue that supports the valve with man-made fiber, or remove tissue so the flaps close more tightly.
Doctors can also implant a ring around the valve to support it. Mitral valve repair is usually done as an open-heart surgery, but there are less invasive procedures available for some patients. If your valve has narrowed due to stenosis, doctors may be able to insert a catheter with a special tip into your groin and maneuver it through your blood vessels to the heart, where they can stretch or open the valve.
Mitral Valve Replacement
If your mitral valve needs to be replaced, ask about the type of valve your surgeon plans to use and why. It may be a biological tissue valve, which is made from cow or pig heart tissue. These may need to be replaced when the tissue breaks down. There are also mechanical valves, which last longer but require patients to take blood thinners for life to prevent blood clots. Factors that affect the recommended type of replacement valve include age, lifestyle, general health, and whether or not you can take blood thinners.
There are various techniques doctors use for mitral valve repair and replacement, so ask your cardiologist or cardiac surgeon about the approach recommended for you and why. Mitral valve surgery has a high success rate, but be aware of risks of bleeding, infection, a malfunctioning valve, or stroke. Mitral valve repairs or replacements can last up to or beyond 20 years.
Ask Your Doctor About Results of Mitral Valve Surgery
Talk to your surgeon about recuperating from mitral valve surgery and your role in making a good recovery. You will stay in the hospital in the ICU for a few days, where you will be closely monitored and given pain medication as necessary. The pain will diminish as you recover. You may feel tired for several weeks and should not exert your upper body or lift heavy objects.
Exercise and a heart-healthy diet, as prescribed by your medical team, can help your recovery. If you had a valve replacement with a mechanical valve, you will have to take blood thinners on an ongoing basis.
More than 100,000 heart valve surgeries are performed each year, many of them on the mitral valve. Most people who have mitral valve surgery regain their energy and can return to their normal daily routine within two months.