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Mitral valve replacement surgery
Mitral valve replacement surgery is typically an open-heart procedure. The damaged heart valve is removed and replaced with a new valve. There are two types of replacement valve: a mechanical heart valve made from plastic or metal or a bioprosthetic heart valve made from animal tissue.
Why is mitral valve replacement surgery done?
Mitral valve regurgitation
For acute mitral valve regurgitation, surgery is done immediately to replace or repair the valve.
For chronic regurgitation, surgery might be recommended if:
- You have symptoms.
- Regurgitation is severe.
- Your heart has pumping problems (low ejection fraction).
- Your left ventricle is larger than normal.
The decision to have surgery also depends on what caused mitral regurgitation. It depends on whether it is caused by:
- A problem with the anatomy of the valve (primary regurgitation).
- Another heart problem (secondary regurgitation).
Mitral valve stenosis
Surgery for mitral valve stenosis might be recommended if:
- Symptoms are present.
- Stenosis is severe.
- Balloon valvuloplasty is not an option.
After mitral valve replacement surgery: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have severe trouble breathing.
- You have severe pain in your chest.
- You have sudden chest pain and shortness of breath, or you cough up blood.
- You have symptoms of a stroke. These may include:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
- A sudden, severe headache that is different from past headaches.
- You have symptoms of a heart attack. These may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
Call your doctor now or seek immediate medical care if:
- You have pain that does not get better after you take pain medicine.
- You have loose stitches, or your incision comes open.
- You are bleeding a lot from the incision.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
- Your heartbeat feels very fast, skips beats, or flutters.
- You have signs of a blood clot, such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
- You have symptoms of heart failure, such as:
- Swelling in your legs, ankles, or feet.
- Sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
- You are sick to your stomach or cannot keep fluids down.
Watch closely for changes in your health, and be sure to contact your doctor if:
- You do not get better as expected.
How well does mitral valve replacement surgery work?
After a diseased mitral valve is replaced, the new valve works more like a normal valve and allows blood to flow more normally through the heart. Many people feel better and have a better quality of life after surgery.
The outcome of mitral valve replacement depends on a person's heart health and overall health, including other health conditions.
How do you prepare for mitral valve replacement surgery?
Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.
Preparing for surgery
- Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
- Understand exactly what surgery is planned, along with the risks, benefits, and other options.
- If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
- Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
- Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.
How can you care for yourself after mitral valve replacement surgery?
Activity
- Rest when you feel tired. Getting enough sleep will help you recover. Try to sleep on your back while you heal. If your breastbone (sternum) was cut, healing usually takes about 4 to 6 weeks.
- Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
- Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or heavy aerobic exercise, until your doctor says it is okay.
- For 3 months, avoid activities that strain your chest or upper arm muscles. This includes pushing a lawn mower or vacuum, mopping floors, or swinging a golf club or tennis racquet.
- For at least 6 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, or cat litter or dog food bags.
- For at least 6 weeks, avoid pushing yourself up out of a bed or chair using your arms. Do not use your arms to pull yourself into or out of a vehicle.
- Hold a pillow firmly over your chest incision when you cough or take deep breaths. This will support your chest and reduce your pain.
- Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
- Ask your doctor when you can drive again.
- You may need to take 4 to 12 weeks off from work. It depends on the type of work you do and how you feel.
- Ask your doctor when it is okay for you to have sex.
Diet
- Eat a heart-healthy diet. If you have not been eating this way, talk to your doctor. You also may want to talk to a dietitian. A dietitian can help you plan meals and learn about healthy foods.
- Drink plenty of fluids (unless your doctor tells you not to).
- You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
Medicines
- Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
- If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
- Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
- Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
- If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
- If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
- Your doctor may give you a blood thinner to prevent blood clots. If you take a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
Incision care
- If you have strips of tape on the incision the doctor made, leave the tape on for a week or until it falls off.
- Wash the area daily with warm, soapy water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
- You can take showers with your back to the showerhead. Allow the warm and soapy water to run across your shoulders and down over the incision. Pat the incision dry with a clean towel.
- Do not take a bath for the first 3 weeks, or until your doctor tells you it is okay.
- Do not swim or use a hot tub for at least 1 month, or until your doctor says it is okay.
- Do not use any creams, lotions, powders, ointments, or oils unless your doctor tells you it is okay.
Other instructions
- Keep track of your weight. Weigh yourself every day at the same time of day, on the same scale, in the same amount of clothing. A sudden increase in weight can be a sign of a problem with your heart. Tell your doctor if you suddenly gain weight, such as 3 pounds or more in 2 to 3 days.
- Be sure to tell all your doctors and your dentist that you have a replacement heart valve. This is important, because you may need to take antibiotics before certain procedures to prevent infection.
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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.