MVR (Mitral Valve Replacement) is a cardiac surgical procedure performed to replace a mitral valve that is not functioning properly. The mitral valve is located between the left heart chambers, i.e., left atrium and left ventricle. The valve replacement is an open-heart surgery; in a few cases, a catheter procedure or minimally invasive surgery may be possible.
Indications for Mitral Valve Replacement
- Mitral Valve Regurgitation: When a mitral valve does not close properly and allows blood to leak back into the left atria.
- Mitral Valve Stenosis: Mitral Valve Stenosis is a condition when a mitral valve does not open fully, results in restricting the blood flow. It may be the result of an infection (infectious endocarditis).
- Severe mitral valve prolapse
Signs and Symptoms of Mitral Valve Disease
Signs and symptoms of mitral valve disease are:
- Heart murmur on auscultation
- Easy fatigue
- Irregular heartbeat
- Swelling in ankles and feet
Tests and Diagnosis for Mitral Valve Replacement
- Physical Examination: The physician will use auscultation to hear a heart murmur of the patient.
- Echocardiography: An echocardiogram helps the doctor to understand the mitral valve and its working.
- Transesophageal Echocardiogram
- Electrocardiogram (ECG): An ECG can detect abnormal heart rhythms, enlarged chambers of heart, and heart disease.
- Chest X-ray
- Stress Tests
- Cardiac MRI
Mitral Valve Replacement Surgery
- Standard blood tests are done to check fitness for surgery.
- The patient is counselled about the procedure and after care.
- An open surgery procedure is performed under general anesthesia.
- An IV line and breathing tube are inserted.
- An incision is made in the middle of the chest, the surgeon separates the sternum to expose pericardium, then opens pericardium to reach to the heart.
- Connects the heart to a heart-lung machine, tubes are used to reroute the blood into a machine that takes over the function of lung and heart during the operation.
- The heart is temporarily stopped and blood removed; the valve is still and allows the surgeon to see it.
- The Cardiologist makes an incision around the edge of the damaged valve and replaces it.
- After valve replacement, the patient usually needs to stay in the hospital for about a week. For the initial days, he/she will be kept in the ICU (Intensive Care Unit.)
- The activity of the patient's heart, lungs and body functions will be closely monitored; the ventilator will be placed until he/she is able to breathe.
- Draining tubes are inserted from the chest to drain away any build-up of fluid or blood.
- Pacing wires, if necessary, will be inserted near the chest drains to control the heart rate of the patient.
- The patient is advised to follow a cardiac rehabilitation program.
- The patient is advised to avoid sudden strains, strenuous exercise and heavy lifting for at least three months.
- The patient will be able to perform usual activities after 4-6 weeks.
- The patient is advised to report to the physician if any warning signs of infection are found.
- The patient should consult the doctor regularly to check the efficiency of the heart valve.
- If the patient has a mechanical heart valve, then anticoagulant medicine is necessary to help prevent clots.
Minimally Invasive Mitral Valve Surgery
In endoscopic surgery, the surgeon makes 1 to 4 small holes in the patient's chest. Surgery is done through the cuts using special surgical tools and a camera.
Robotic-Assisted Valve Surgery
The surgeon makes 2 to 4 tiny cuts in the patient's chest. A special computer is used by the surgeon to control robotic arms during the surgery.