Mitral valve replacement is a cardiac surgery involving the replacement of mitral valve located in the heart. The mitral valve is one of the hearts four valves and is located between left atrium and left ventricles. It helps blood flow through the heart and out of the body. The surgery is performed in open method where the incision is larger and the heart is more exposed.
The procedure is usually performed when mitral valve is working poorly which happens in case of mitral valve stenosis and mitral valve regurgitation (also known as mitral insufficiency). In mitral valve stenosis, the leaflets become too thick or stiff and may fuse together. This results in a narrowed valve opening and reduced blood flow through the valve. In mitral regurgitation, the valve becomes leaky. Your heart pumps blood which goes in one direction. This is caused by the mitral valve. If mitral valve is working properly, the valve opens up and allows blood to flow out of the atrium, which is located above it. The valve closes back up immediately. However, it does not close properly allowing some blood to flow back up to the atrium. This is called mitral regurgitation. Both of these conditions results from general aging of the valve. However, other causes may include ischemic heart disease (coronary artery disease), infection of the heart valves, heart failure and rheumatic fever.
When undergoing mitral valve replacement surgery, there are some pre-planning involved. One of the things that should be decided with your doctor is the type of valve to be placed in your heart. It is either biological or mechanical valve. Biological valves or bioprosthetic valves are made of mainly from pig, cow or human heart tissues. These usually don’t last as long as mechanical ones but lead to blood clots. Mechanical valves are made of artificial components like carbon and polyester materials for which one requires blood thinning medications for life. Your doctor will also advise you to stop smoking or eating or drinking the night before. Moreover, your doctor will do some tests including chest x-rays, electrocardiogram, blood tests, echocardiogram and coronary angiogram (to assess blood flow in your heart arteries).
The surgery will involve giving anesthesia to the patients so that he or she does not experience any pain during the procedure. The doctor will likely make an incision alongside your chest and perform the surgery, replacing the mitral valve with the biological or mechanical valve. The doctor will try to preserve as much of the supporting valve as possible.
After the surgery, you will be taken to the ICU (intensive care unit). You will be given fluids, nutrition and medications through intravenous tubes. There will be tubes connected to your bladder to drain your urine and the other will be connected to your heart to drain any fluid from your lungs and heart. You also might need extra oxygen. After a few days at the ICU, you will be moved to a regular room. You will be kept in the hospital for a few days to monitor your condition and watch for any signs of any infection. Also, your breathing rate, blood pressure and heart rate will be checked and given pain medications depending on your pain level.
Any person suffering from mitral valve stenosis or regurgitation can have the surgical procedure. The symptoms of both these conditions include fatigue, dizziness, shortness of breath, cyanosis, chest pain and fluid retention, especially in the lower limbs.
Any person suffering heart valve disease but showing mild symptoms which can be treated with medications is not eligible for the treatment.
Due to the nature of mitral valve replacement which is open, there are numerous side effects to the procedure. Some of these includes infection at the surgical site, bleeding, irregular heart rhythms, blood clots leading to a stroke or heart attack, continued leaking of the valve, damage to nearby organs and memory loss or problems with concentration. There might be added complications from anesthesia that may include temporary confusion, dizziness and shivering and feeling cold. All these side effects depends on your health, your age and other factor including chronic illness, heart problems, lung problems, increased age, being obese, smoking and infections. Contact your doctor if you experience any of these effects.
Following your discharge from the hospital, you will be required to come and visit your doctor after four or six weeks to check your surgical site for infection and any sort of swelling or discomfort. Your doctor will ask you to monitor your temperature and weight fluctuations. Don’t drive in your post-recovery period and also avoid lifting anything heavy for at least one to two weeks.
You should also follow a strict diet that will be more balanced and nutrient rich. Make sure to eat a variety of fruits, vegetables, whole grains, breads, lean means like fish and low-fat dairy products. Foods having high saturated fats, sugar and sodium should be limited. Also, processed meats should also be avoided. Do not use calcium supplements without asking your doctor. In terms of physical activity, try to increase your exercise rhythm and time slowly. However, ask your doctor before beginning or doing any sort of physical activities.
Recovery time will depend on your over all health and type of mitral valve replacement surgery performed. It usually takes 1 to 2 months for full recovery and resume normal activities for a patient but can lake longer.
The pricing of mitral valve replacement generally range from Rs. 3,50,000 and go up to Rs. 7,00,000. However,on an average a open mitral valvereplcement cost around Rs.5,00,000.
Yes, the results are permanet and provide relief to patients.
Alternative to mitral valve replacement includes mitral valve repair where the valve is repaired through minimally invasive surgery.