Mitral valve surgery - open
Definition
Blood that flows between different chambers of your heart must flow through a valve. This 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.
Mitral valve surgery is surgery to either repair or replace the mitral valve in your heart.
In open surgery, the surgeon makes a large incision (cut) in your breastbone to reach the heart.
See also: Mitral valve surgery - minimally invasive
Alternative Names
Mitral valve replacement - open; Mitral valve repair - open; Mitral valvuloplasty
Description
Before your surgery, you will receive general anesthesia. This will make you unconscious and unable to feel pain 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 aortic 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 1 or more of the 3 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 main types of new valves:
- Mechanical -- made of man-made materials, such as cloth, metal, or ceramic. 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 12 to 15 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.
This surgery may take 3 to 6 hours.
Risks
Risks for any surgery are:
- Reactions to medicines
- Breathing problems
- Blood clots in the legs that may travel to the lungs
- Infection, including in the lungs, kidneys, bladder, chest, or heart valves
- Blood loss
Possible risks from having open-heart surgery are:
- Heart attack or stroke
- Incision infection, which is more likely to happen in people who are obese, have diabetes, or have already had this surgery
- Post-pericardiotomy syndrome, which is a low-grade fever and chest pain. This could last up to 6 months.
- Memory loss and loss of mental clarity, or "fuzzy thinking."
- Heart rhythm problems
Reviewed By: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA.. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
