Mitral Valve Replacement

What it is

The mitral valve is on the left side of the heart. It allows blood to flow from the left upper chamber into the left lower chamber. When the valve is not working well, it may need to be replaced.

Reasons for Procedure

Healthy heart valves allow blood to flow one way. Diseased valves either leak and cause back flow or narrow and restrict flow. The condition can be life threatening. Sometimes the valve can be repaired. Other times, it must be replaced. Rheumatic fever, infections, defects at birth, and wear and tear are the most common causes of mitral valve problems.

Possible Complications

If you are planning to have a mitral valve replacement, your doctor will review a list of possible complications, which may include:

• Infections
• Bleeding
• Stroke
• Damage to other organs, such as the kidneys
• Irregular heart rhythm
• Death

Some factors that may increase the risk of complications with heart surgery include:

• Lung disease, especially chronic obstructive pulmonary disease (COPD) (emphysema)
• Prior heart attack or cardiac surgery
• Obesity
• Diabetes
• Smoking
• Kidney disease

What to expect

Prior to Procedure
Your doctor will likely do the following:

• Physical exam
• Chest X-ray
• Lab work
• Echocardiogram
• Electrocardiogram (ECG, EKG)
• Cardiac catheterization

Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as:

• Blood-thinning drugs, such as warfarin (Coumadin)
• Anti-platelet drugs, such as clopidogrel (Plavix)
• Diabetes medications, such as metformin (Glucophage)

Your doctor may also ask you to:

• Eat a light meal the night before. Do not eat or drink anything after midnight.
• Arrange for a ride to and from the hospital.
• Arrange for help at home after the procedure.

Anesthesia

General anesthesia will be given. You will be asleep during the procedure.

Description of Procedure

An incision will be made down the middle of your chest and the breast bone will be separated. A heart-lung machine will be attached, which allows the doctor to stop your heart to safely work on the heart valve.

Immediately After Procedure

You will be monitored in the intensive care unit, where you will have the following interventions:

• Heart monitor
• Pacing wires to control heart rate
• Tubes connected to a machine to drain fluids from the wound
• Breathing tube or an oxygen mask
• Catheter inserted into the bladder

How Long Will It Take?

The surgery can take anywhere from 3 to 6 hours.

How Much Will It Hurt?

Anesthesia prevents pain during surgery. You may be given medication for any pain during recovery. Pain levels vary from patient to patient.

Average Hospital Stay

The average stay is 3 to 6 days.

Post-procedure Care

At the Hospital

• To reduce the risk of fluid buildup in your lungs, you will be instructed to breathe deeply and cough 10 to 20 times every hour.
• Efforts will be made to get you out of bed and walking as soon as possible.
• Dressings will be removed in a day or two. Pacing wires and chest tubes will be removed within the first few days.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Take medicines as directed by your doctor, such as:
  • Antiarrhythmics
  • Blood thinners (If you have a mechanical valve, you will have to take blood-thinning medicines for the rest of your life. This will help to prevent blood clots. If you have a tissue valve, you will need to take blood-thinning medicine for six weeks to three months after surgery)
  • Cholesterol-lowering medicine
  • Blood pressure medicine
  • Pain medicine
  • You may also need to take antibiotics during dental procedures and during certain other procedures as this will help prevent a valve infection
• Follow your doctor’s guidelines for caring for your incisions
• Weigh yourself every morning
• Be sure to follow all of your doctor’s instructions

Recovering after Surgery/What to Expect

Every patient’s recovery can be different. You will need to shower, daily, with a mild soap. Ask your doctor when it is safe to take a bath or soak in water. You may find that there will be some areas of discomfort in the area of surgery that can last for several weeks. Also, it is common that you may feel tired for many weeks following this type of surgery.

You will be asked not to do any type of heavy lifting for two months that will cause pain at the surgical site. People with jobs requiring strong physical activity may require additional time before resuming those types of activities. Be sure to ask your doctor when you can drive and return to work.

When to Call Your Surgeon:

• Pain that you cannot control with the medication you have been given
• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision sites
• Nausea and/or vomiting that you cannot control with the medication you were given after surgery or that lasts longer than expected
• Cough, shortness of breath, or chest pain
• Pain, burning, urgency, frequency of urination, or persistent blood in the urine
• Gaining more than four pounds within one or two days
• Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain

In case of an emergency, call for medical help right away.

Meet with a doctor within 1 week

To learn more about how we can help you, contact us. We’ll return your call the same day and can secure you an appointment with one of our doctors within the week.

Call 617.789.2045 to request an appointment.