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Mitral valve surgery - open

Alternative Names: Mitral valve replacement - open; Mitral valve repair - open; Mitral valvuloplasty

Mitral valve surgery is surgery that can either repair or replace the mitral valve in your heart.

Blood that flows between different chambers of your heart must flow through a valve. One such valve is called the mitral valve. It opens up enough so blood can flow from one chamber of your heart (left atria) to the next chamber (left ventricle). It then closes, keeping blood from flowing backwards.

In open surgery, the surgeon makes a large cut in your breastbone to reach the heart.

See also: Mitral valve surgery - minimally invasive

Description of Procedure

Before your surgery, you will receive general anesthesia. This will make you asleep and pain-free during the entire procedure.

  • Your surgeon will make a 10-inch-long cut in the middle of your chest.
  • Next, your surgeon will separate your breastbone to be able to see your heart.
  • Most people are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart while your heart is stopped.
  • A small cut is made in the left side of your heart so your surgeon can repair or replace the mitral valve.

If your surgeon can repair your mitral valve, you may have:

  • Ring annuloplasty -- The surgeon repairs the ring-like part around the valve by sewing a ring of metal, cloth, or tissue around the valve.
  • Valve repair -- The surgeon trims, shapes, or rebuilds one or more of the three leaflets of the valve. The leaflets are flaps that open and close the valve.

If your mitral valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your mitral valve and sew a new one into place. There are two types of mitral valves:

  • Mechanical -- made of man-made (synthetic) materials, such as a metal like titanium. These valves last the longest, but you will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life.
  • Biological -- made of human or animal tissue. These valves last 10 to 12 years, but you may not need to take blood thinners for life.

Once the new or repaired valve is working, your surgeon will:

  • Close your heart and take you off the heart-lung machine.
  • Place catheters (tubes) around your heart to drain fluids that build up.
  • Close your breastbone with stainless steel wires. It will take about 6 weeks for the bone to heal. The wires will stay inside your body.

You may have a temporary pacemaker connected to your heart until your natural heart rhythm returns.

Your surgeon may also perform coronary artery bypass surgery at the same time, if needed.

This surgery may take 3 - 6 hours.

Risks of Mitral valve surgery - open

Risks for any surgery are:

Possible risks from having open-heart surgery are:

  • Heart attack or stroke
  • Heart rhythm problems
  • Infection in the cut, which is more likely to happen in people who are obese, have diabetes, or have already had this surgery
  • Memory loss and loss of mental clarity, or "fuzzy thinking."
  • Post-pericardiotomy syndrome, which is a low-grade fever and chest pain. This could last for up to 6 months.

Learn more about Mitral valve surgery - open

Review Date: 1/26/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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