Blood flows from the lungs and enters a chamber of the heart called the left atrium, and then flows into the chamber of the heart called the left ventricle. The mitral valve is located between these two chambers. It makes sure that the blood keeps moving forward through the heart. Mitral valve replacement is a surgery to replace a poorly working mitral valve with an artificial valve. It can be done as an open surgery with large incisions or Minimally Invasive Cardiac Surgery (MICS) with smaller incisions.
There are mainly two problems of the mitral valve which requires its replacement: In mitral valve stenosis, the valve is unable to open fully, and less blood is able to move from the left atria into the left ventricle. And in mitral valve regurgitation, the valve is leaky. Some blood leaks back into the left atrium instead of moving forward into the left ventricle. These valve problems can lead to such symptoms as fatigue and shortness of breath. If these symptoms become severe, surgery may be necessary.
PREPARING FOR THE SURGERY
You will be undergoing a detailed physical examination and investigations, to your doctor understand the overall health of your body and that no other existing condition is there which can lead to complications post-surgery. 1-week before the surgery, you may be asked to stop taking medicines that make it difficult for your blood to clot because such medicines might cause increased bleeding during the surgery. Once, the surgery is decided your surgeon will decide if your valve will be replaced with a biological valve (made of cow, pig or other human tissue) or mechanical valve (man-made) and risks for both types will be explained to you. You will be instructed not to eat or drink 12 hours before the surgery.
ON THE DAY OF THE SURGERY
Mitral Valve Replacement is done under general anaesthesia means you will be asleep during the surgery. Cardiac Surgeon will make an incision down the middle of your chest. Your breastbone and muscles will be separated to access your heart. You will be attached to a heart-lung machine. You will be connected to heart-lung machine through small cuts in the groin or on the chest. This machine will act as your heart and lungs during the procedure. Surgeon will remove your current mitral heart valve and replace it with a new valve. After the mitral valve replacement, Heart-lung machine will be removed and your breastbone will be wired together and incision in your skin will be closed though staples and dressing will be done. The surgery may take 2 to 4 hours to complete.
After the surgery you will be shifted to the intensive care unit (ICU) and recover there for 1 or 2 days. Nurses will closely watch monitors that display your vital signs (pulse, temperature, and breathing). Two to three tubes will be in your chest to drain fluid from around your heart. They are usually removed 1 to 3 days after surgery. You may have a catheter in your bladder to drain urine. You may also have intravenous (IV) lines to get fluids. Once your vital signs become stable, you will be shifted from the ICU to a regular hospital room. Your heart and vital signs will be monitored until you are ready to go home. You will receive pain medicine for pain in your chest. Nurses will help you to start activity slowly. You may begin a program to make your heart and body stronger. A pacemaker may be placed in your heart if your heart rate becomes too slow after surgery. You will be instructed to perform breathing therapy to help remove fluids that collect in your lungs during surgery. This may be temporary or you may need a permanent pacemaker before you leave the hospital. You will be required to stay in hospital for 3-5 days.
You may feel tired easily after the surgery, but you will gradually start to recover your strength. Immediately after the surgery, you will be encouraged to get up, to breathe deeply, and to resume eating, drinking and walking. The normal recovery time after a heart valve surgery is usually four to eight weeks. If you underwent minimally invasive procedure you may recover faster as compared to open heart surgery procedure. You may start doing basic activities after few weeks. During your recovery, find out what pace is right for you as you work your way toward a physically active lifestyle. Under your practitioner’s guidance, you should gradually build up your exercise and activity level. Before you begin a new strenuous activity, make sure it’s okay and find out if you have any guidelines to follow concerning your heart rate or level of exertion. To improve overall cardiovascular health, follow a regular exercise program that includes moderate physical activity.
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Q: What is the success rate of Mitral Valve Replacement surgery?
A: A recent study found that aortic valve replacement surgery has a 94 percent five-year survival rate.
Q: Which type of valve is better Biological or Mechanical?
A: Usually a mechanical valve last longer but it requires you to take blood thinning medications throughout your life. Biological valve lasts about 15 years but may require to be replaced.
Q: What are the symptoms of a leaking mitral valve?
A: Many patients with mitral valve disease have no symptoms. Some symptoms include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations.
Q: When can I get back to my work?
A: 2 weeks after the surgery you can start basic sitting job, for heavy manual work wait for at least 8 weeks or so.
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