The mitral valve, which sits between the left heart chambers, keeps the blood moving in the correct direction. However, some individuals develop mitral valve disease, which causes blood to leak backward or leads to reduced blood flow due to narrowed valves. In such cases, an expert may recommend mitral valve surgery to fix or replace the affected valve in the heart.

What are the types of mitral valve surgery?
There are two types of this procedure: mitral valve repair and replacement. These are carried out to fix or replace a leaky or stiff mitral valve in the heart.

• Mitral valve repair
  During a mitral valve repair surgery, a healthcare expert may patch holes in the valve, remove excess tissue to allow the flaps to close tightly, or reconnect the valve leaflets. The expert may also repair the structure of the valve by replacing the cords that support it or separate the valve leaflets that have fused due to the disease.
• Mitral valve replacement
  In surgeries involving mitral valve replacements, the doctor will remove the valve and replace it with a mechanical one made from biological tissue, such as cow, pig, or human heart tissue. The expert may sometimes use a catheter to insert the new valve into the one that no longer works properly. This is known as a valve-in-valve procedure.

The repair or replacement surgeries may be performed as open-heart or minimally invasive surgeries. The doctor will choose a type after examining the patient and considering how severe the problem is. In most cases, experts may recommend repairing the mitral valve as far as possible. The repair-oriented method helps avoid complications usually occurring with mitral valve replacements, such as blood clots and biological tissue valve failure.

When is the surgery recommended?
A mitral valve surgery, or another procedure to repair or replace a mitral valve, might be required if one has a mitral valve disease, such as:

• Mitral valve regurgitation
  Sometimes, the mitral valve’s flaps do not close tightly, compelling blood to leak backward. This condition is common in people with mitral valve prolapse. A repair surgery might be indicated for people with severe mitral valve regurgitation symptoms.
• Mitral valve stenosis
  Surgery may also be recommended if the valve leaflets become thick or stiff and fuse. The complication causes the valve to become narrowed and reduces blood flow through the area.

If a healthcare expert identifies mild mitral valve disease following a diagnosis, one might need to make frequent appointments to monitor their heart health. The individual might also need to take other treatments to manage the symptoms.

One should note that mitral valve repair or replacement might be required even if there are no visible symptoms. Experts indicate that people with severe mitral valve regurgitation who have no symptoms may still benefit from surgery in the long term.

Are there any risks?
Whether one undergoes mitral valve repair or replacement surgery, one should know about the potential risks involved. A few risk factors include:

• Blood clots
• Bleeding
• Infection
• Stroke
• Irregular heartbeats
• Malfunction of the replacement valve

Do patients need to stay in the hospital to recover post surgery?
Regardless of whether one undergoes mitral valve repair or replacement surgery, the healthcare expert may issue particular guidelines for recovery, which the patient will need to follow. For instance, one might have to spend a day or more in the intensive care unit. The duration of the stay in the hospital will differ based on one’s specific condition and surgery. During the stay, one might receive oxygen support and fluid solutions through an IV to alleviate pain. The experts will also check one’s blood pressure, heart rate, and breathing and conduct other diagnostic tests to ensure recovery is as expected or to detect and resolve potential complications early.

Through one’s recovery at the hospital, the healthcare professional may ask the patient to gradually increase activity, indulge in breathing exercises, and take longer walks around the premises. The patient may also receive other instructions they must follow during recovery, such as how to care for the incisions, which treatments to take and their side effects, and how to look for the signs of potential infection and decide if intervention by a trained professional is required.

What care should patients take after returning home?
A surgery that involves mitral valve repair or replacement may help reduce the symptoms and improve one’s quality of life. However, there are a few things one will need to keep in mind when it comes to managing the condition at home:

• Those who undergo valve replacements with a mechanical valve will require life-long treatments to thin the blood and prevent blood clots.
• Biological tissue valves may break down with time and eventually need replacement.
• Frequent health checkups are mandatory to ensure the new or repaired valve functions normally.
• A healthcare provider may recommend an educational program and exercise to help one improve their health and recover after heart surgery.
• The expert may also recommend a healthy lifestyle before and after the mitral valve surgery, such as regular exercise, eating healthy meals, and managing stress.