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Cardiac & Heart Surgeries

Cardicac Valve Replacement / Repair (AVR/MVR)

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
  • Breathlessness
  • 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 


Before Procedure 

  • Standard blood tests are done to check fitness for surgery.
  • The patient is counselled about the procedure and after care. 

During Procedure 

  • 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 Procedure 

  • 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.



Dr. Devi Prasad Shetty

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