Mitral valve repair is surgery to repair a diseased or defective mitral valve. The surgery may be open heart or minimally invasive surgery depending on your age, health condition and other factors.
Ohio State's Wexner Medical Center offers a team approach to heart valve surgery, which means each patient is evaluated by a cardiologist, a cardiac surgeon, an imaging specialist, interventional cardiologist and an anesthesiologist. This integrated approach means that each patient’s heart valve disease is treated individually, with that particular patient’s needs – and physical condition – in mind. In addition, we offer both minimally invasive surgery and robotic heart surgery, which result in smaller incisions, reduced hospital stays and shorter recovery times. Open heart surgery is also available if that is determined to be the best treatment option.
What Is Mitral Valve Repair?
Mitral valve repair addresses a malfunctioning mitral valve and the symptoms you have. Mitral valve repair allows for the existing tissue to remain intact or minimal removal of diseased tissue. Repair of the valve involves fixing the leaflets (flaps) with sutures and placing a plastic ring around the structure to reinforce the repair and prevent future leaks. This type of repair is called mitral valve annuloplasty.
You may be a candidate for minimally invasive surgery, which surgeons at The Ohio State University Wexner Medical Center specialize in.
Why Have a Mitral Valve Repair?
When heart valves are severely malformed or destroyed, they may need to be repaired. Conditions that may require you to have mitral valve repair include:
Physicians prefer to repair a defective or diseased mitral valve whenever possible. According to physicians at The Ohio State University Wexner Medical Center, approximately 90 percent of damaged mitral valves can be repaired rather than replaced.
What to Expect During Mitral Valve Repair
Preparing for Your Procedure
Prior to mitral valve repair, you’ll meet with your physician to discuss your medical history, medications you take and any questions you have. Avoid eating or drinking for at least eight hours before the procedure.
Tests you may have to prepare for surgery include:
- Chest X-ray – A radiograph or picture of the heart and lungs including blood vessels, ribs and bones of the spine.
- Blood tests – Studies to detect enzymes that leak into the blood when the heart has been damaged and to detect infection and antibodies.
- Urine tests
- Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart.
- Cardiac catheterization – A procedure to check for problems in coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.
- CT angiogram (CTA - computed tomography angiogram) – An imaging procedure that uses CT technology to produce cross-sectional, detailed images of blood vessels.
- Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves.
Prior to surgery, your health care team may show you how to use a breathing exerciser. After your surgery, you will need to take deep breaths and cough frequently to prevent pneumonia. Practicing before surgery can make this easier to do after surgery.
If you use tobacco, you will be instructed to quit at least two weeks before surgery. Tobacco use can interfere with the blood’s ability to clot properly. Your physician can prescribe a nicotine-replacement product to help you stop tobacco use.
As in the case of most surgeries, your physician will ask you to not eat or drink a certain number of hours beforehand, often nothing after midnight the night before.
The area where your incision will be made is shaved and cleaned prior to surgery to reduce risk of infection. You will be given anesthetic medication to put you “to sleep” during surgery.
During Your Procedure
You are connected to monitoring equipment (electrocardiogram) to check your heart’s activity during the procedure. You also have an intravenous line in your arm to provide anesthesia throughout the procedure. A mechanical respirator breathes for you during the surgery, via a tube inserted in your windpipe. Another tube, inserted in your nose and through your throat, prevents air and liquid from pooling in your stomach. Still another tube, a catheter, is inserted into your bladder.
Heart valve surgeries require the use of a heart-lung machine. This keeps blood flowing during the procedure. The machine takes over this function for your body, and your body takes over again when the procedure is completed.
The surgeon makes an incision in your chest to access your valve. The repair is made, your heart is restarted, and the heart-lung machine is disconnected. Traditional valve surgery takes several hours.
If you have robotic heart surgery or minimally invasive surgery, the incision is much smaller and the hospital stay and recovery time are shorter.
After Your Procedure
If you have open-heart valve surgery, you may remain in the hospital for as long as a week or two.
Your medical team will help you get up and about one or two days after surgery. You may feel stiff and sore, but it is important to breathe deeply and cough to clear fluids from your lungs. You will be allowed to eat normally in most cases.
If your job involves primarily sitting at a desk, you usually can return to work in four to six weeks.