What is Mitral Valve Surgery

Dr Foram Bhuta

Dr Foram Bhuta

BDS (Bachelor of Dental Surgery), 10 years of experience

December 16, 2021 Heart Diseases 500 Views

English हिन्दी Bengali

What is the meaning of Mitral Valve Surgery?

Mitral valve surgery is a surgical procedure to repair or replace the damaged mitral valve. This procedure is used to treat valvular heart diseases. The mitral valve is one of the four valves in the heart. It is located between the left chambers of the heart, i.e., the left auricle and the left ventricle of the heart. 

Let us tell you in detail about mitral valve surgery in today’s article.

  • What are the causes for Mitral Valve Surgery?
  • What are the symptoms of Mitral Valve Diseases that need Mitral Valve Surgery?
  • What are the diagnostic tests for Mitral Valve Surgery?
  • What is the preparation before Mitral Valve Surgery?
  • What is the procedure of Mitral Valve Surgery?
  • What is the after-care required after a Mitral Valve Surgery?
  • What are the risks of Mitral Valve Surgery?
  • What is the cost of Mitral Valve Surgery in India?

What are the causes for Mitral Valve Surgery?

Mitral Valve Repair Surgery is often preferred over Mitral Valve Replacement Surgery. This is because the efficacy of an artificial mitral valve is not as good as a normal mitral valve. However, if the mitral valve has been damaged beyond repair, then replacement is the only option for treatment. The doctor considers the age of the patient and the patient’s overall health condition to decide whether or not to have surgery.

Mitral valve surgery is performed to treat the following valvular heart diseases-

Mitral Valve Regurgitation:

  • When the mitral valve does not close completely it is known as Mitral Valve Regurgitation.
  • This condition causes the blood to flow in the backward direction instead of the forward direction through the mitral valve.

Mitral Valve Stenosis:

  • In this condition, the mitral valve fails to open properly and becomes narrow.
  • This stops the blood flow outside the chambers of the heart.
  • Because of this, the heart is forced to pump the blood with an increased force to move the blood through the stiff mitral valve.

Coronary artery disease / Ischemic heart disease: This is a heart condition where the blood vessels supplying blood to the heart become narrow due to plaque deposits. This decreases the blood flow to the heart and leads to symptoms like chest pain, shortness of breath or heart attack, etc. (Know more: What is Heart Bypass?)

Heart failure: This is a progressive heart condition where the heart muscles are weak and the heart is unable to pump sufficient blood to the body. Thus, the needs of adequate blood and oxygen of the body are not fulfilled. This leads to chronic symptoms like chest pain, swollen feet and abdomen, etc. This condition is serious and requires Valve surgery. 

Rheumatic fever: This is a streptococcal bacterial infection which causes inflammation and infection of the heart valves, blood vessels and joints.This causes mitral valve scarring that leads to mitral valve stenosis, which leads to serious heart problems.

Endocarditis: This is the infection of the heart’s inner lining. Most commonly the heart valves are infected. The infection is usually present in other parts of the body and travels to the heart via blood. People with artificial or damaged heart valves are most commonly affected.

Mitral valve prolapse that cannot be treated by medications: In this condition the mitral valve bulges back into the upper left chamber of the heart while the heart muscle contracts to supply blood. This can be heard as heart murmur by the doctor. In cases when this condition can not be treated with medications, Mitral Valve Surgery is required to correct the damaged Mitral Valve.

What are the symptoms of Mitral Valve Diseases that need Mitral Valve Surgery?

Mitral valve surgery is needed when the patient has the following symptoms- 

  • Fatigue or tiredness
  • Chest pain
  • Dry cough or cough with mucus
  • General weakness or inability to carry regular daily activities
  • Loss of appetite
  • Shortness of breath which progresses over time and may be present at night, while walking, sleeping,etc.
  • Weight gain and feeling of bloating 
  • Dizziness or fainting feeling
  • Palpitations or rapid heart beats 
  • Swelling in the legs, feet, hands or abdomen

What are the diagnostic tests for Mitral Valve Surgery?

Following a complete physical examination, the doctor performs the following diagnostic tests before the mitral valve surgery to determine the condition of heart and mitral valve damage-

  • ECG / Electrocardiogram is done to check the irregular heart beats by using electrical signals.
  • Echocardiogram is done to determine the severity of mitral valve damage by using high frequency sound waves that give the images of the heart. It helps the doctor to determine the blood flow through the mitral valve.
  • Chest X-rays are done to get images of the heart ( if enlarged) , lungs and major blood vessels related to the heart.
  • Cardiac MRI is done to get pictures of the heart chambers, valves, size and blood flowing through the major blood vessels of the heart and the surrounding structures of the heart, which helps the doctor to assess the severity of the heart condition.
  • Stress test is done to evaluate the functioning of the heart under exercises and medications (stress related conditions). This helps to see if the diseased mitral valve is limiting the person’s ability to work.
  • Coronary angiogram is a X- ray imaging test that helps the doctor to evaluate the conditions of the heart’s major blood vessels. ( Know more about- What is Coronary Angioplasty? Causes, Procedure and Cost )
  • Blood tests like cholesterol test,  C-reactive protein test, lipid profile, Complete blood count (CBC), Haemoglobin level, blood sugar levels, etc may be asked by the doctor.

What is the preparation before Mitral Valve Surgery?

The preparation done before the mitral valve surgery should include:

  • Inform your doctor if there is any pregnancy or possibility of pregnancy before the surgery.
  • The doctor should know about any drugs, medications, or supplements that you may be taking.
  • The doctor should be informed about any pre-existing medical conditions or disorders a patient may have before the surgery.
  • The doctor should be informed about any minor illness, like common cold or cough, that the patient may have a day before the surgery.
  • It is advisable to stop smoking for at least two to three weeks before the surgery to prevent any breathing problems or bleeding during the surgery.
  • The patient may be advised to stop certain medications like Ibuprofen, aspirin, and blood-thinners like warfarin or clopidogrel a couple of days before the surgery. These medications lead to increased bleeding during surgery. Stopping  any medicines that a patient may be taking regularly should be done only after consulting your doctor.
  • Some antibiotics may be prescribed before the procedure to avoid infection.
  • The doctor may ask you to wash and clean yourself thoroughly the night before the surgery using a special type of soap to kill germs.
  • The patient is advised to avoid any food or drinks after midnight, the day before the surgery. 

What is the procedure of Mitral Valve Surgery?

Mitral Valve Surgery is done under general anesthesia.

Mitral Valve Surgery can be performed in the following different ways:

Minimally invasive Mitral Valve Surgery

  • The surgeon gives a 2 to 3-inch incision along the right part of the chest near the breastbone. 
  • Muscles in this area are then divided to reach the heart.
  • A small cut is then made on the left side of the heart to repair or replace the mitral valve.

Endoscopic Surgery

  • In this type of surgery, the surgeon makes one to four small holes in the chest region.
  • Mitral valve surgery is then performed through these cuts using the camera on the endoscope and special surgical tools.

Robotically-assisted mitral valve surgery

  • In this kind of surgery, 2 to 4 tiny cuts are made in the chest region. These cuts are about 1.5 to 2 centimeters each.
  • The surgeon will make use of a special computer to control the arms of the robot during the surgery.
  • The surgeon can see a complete 3D view of the heart and the mitral valve on a computer in the operating room.

Percutaneous Valvuloplasty

  • Surgery may also be performed through a groin artery and is called percutaneous valvuloplasty (in patients who are too unwell to have general anesthesia because the results are usually not long-lasting). 
  • These types of surgery will require a heart-lung (bypass) machine during the time of the surgery, which carries out the function of pumping out blood. The patient is given small cuts on the chest or the groin region to connect to the device.

Ring Annuloplasty:

The Mitral Valve Repair Surgery can be done using Ring Annuloplasty, in which the surgeon sews a ring of cloth, metal, or tissue around the mitral valve. Valve repair procedure includes the trimming, shaping, and rebuilding of one or both the flaps that open and closes the valve.

Mitral Valve Replacement Surgery: 

If there is a lot of damage to the mitral valve the surgeon may remove some of the mitral valve, or the complete mitral valve. This is known as Mitral Valve Replacement Surgery. The artificial valve  may be of two types:

  • Mechanical- It is made up of man-made materials like carbon and titanium. The patient may require blood-thinners for life in such cases.
  • Biological- It is made up of animal or human tissue. The patient will not require blood-thinners for life in such cases.

What is the after-care required after a Mitral Valve Surgery?

  • After mitral valve surgery, the patient stays in the Intensive Care Unit (ICU) for a day or two where the nurse monitors the vital signs of the patient such as pulse rate, breathing, temperature, and heart rate, and is then shifted to a normal recovery room. The patient is expected to stay in the hospital for 3 to 5 days. 
  • About two to three tubes are placed in the chest for draining out the fluid from the heart. These tubes are removed 1 to 3 days following the surgery.
  • A temporary or permanent pacemaker may be placed in the patient’s heart after the surgery if the heart rate goes down too much after the surgery.
  • After going home, the patient should maintain proper hygiene to prevent infection.
  • The prescribed medications should be taken regularly.
  • The patient should avoid strenuous physical activity after the surgery.
  • Ask your doctor before returning to your daily work.
  • Ask your doctor when it would be safe to drive again.
  • Include mineral and vitamin-rich foods in your diet. Know more about- Diet for Heart Patients )
  • Check for temperature changes and changes in weight every day. Let your doctor know if your temperature goes above 100.4°F, or if there is a drastic weight change.
  • One should regularly go for follow-up appointments with the doctor post-surgery and recovery.

If the patient experiences any symptoms or complications post-surgery, the doctor should be contacted immediately.

What are the risks of Mitral Valve Surgery?

There are some risks associated with every surgical procedure. Similarly, mitral valve surgery may also involve the following complications:

  • Damage to other surrounding organs, nerves, or bones
  • Infection in the new valve
  • Infection in the lungs, kidneys, chest, or bladder
  • Bleeding
  • Heart attack  ( Know more about- What is Heart attack?)
  • Stroke
  • Irregular heartbeats 
  • Difficulty in breathing
  • Poor wound healing 
  • Kidney failure
  • Arrhythmia or irregular heart beats ( Know more about- What is Heart Bypass Surgery ? )
  • Blood clot formation in the legs, that may go to the lungs.
  • Allergic reaction to medications

What is the cost of Mitral Valve Surgery in India?

The cost of mitral valve surgery in India can range from around INR 3,25,000 to INR 5,25,000. There are many large hospitals and experienced doctors in India who perform mitral valve surgery. The cost of mitral valve surgery may vary across different hospitals.

If you are coming from abroad, apart from the cost of mitral valve surgery, there will be some additional expenses such as the cost of staying in a hotel, cost of local travel, etc. Apart from this, after the procedure, the patient usually stays in the hospital for around 8 days and in the hotel for around 10 days for recovery. So, the total cost of mitral valve surgery in India comes to INR 5,55,000.

We hope that we could answer your questions regarding mitral valve surgery through this article.

If you want to get more information and treatment of mitral valve surgery, you can contact a Cardiac Surgeon.

We only aim to give you information through this article. We do not recommend medication or treatment in any way. Only a qualified doctor can give you the best advice and treatment plan. 

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