Definition of Mitral valve surgery - open:

Mitral valve surgery is surgery that can either repair or replace the mitral valve in your heart.

Blood that flows between different chambers of your heart must flow through a valve. One such valve is called the mitral valve. It opens up enough so blood can flow from one chamber of your heart (left atria) to the next chamber (left ventricle). It then closes, keeping blood from flowing backwards.

In open surgery, the surgeon makes a large cut in your breastbone to reach the heart.

See also: Mitral valve surgery - minimally invasive

Description:

Before your surgery, you will receive general anesthesia. This will make you asleep and pain-free during the entire procedure.

• Your surgeon will make a 10-inch-long cut in the middle of your chest.
• Next, your surgeon will separate your breastbone to be able to see your heart.
• Most people are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart while your heart is stopped.
• A small cut is made in the left side of your heart so your surgeon can repair or replace the mitral valve.

If your surgeon can repair your mitral valve, you may have:

• Ring annuloplasty -- The surgeon repairs the ring-like part around the valve by sewing a ring of metal, cloth, or tissue around the valve.
• Valve repair -- The surgeon trims, shapes, or rebuilds one or more of the three leaflets of the valve. The leaflets are flaps that open and close the valve.

If your mitral valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your mitral valve and sew a new one into place. There are two types of mitral valves:

• Mechanical -- made of man-made (synthetic) materials, such as a metal like titanium. These valves last the longest, but you will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life.
• Biological -- made of human or animal tissue. These valves last 10 to 12 years, but you may not need to take blood thinners for life.

Once the new or repaired valve is working, your surgeon will:

• Close your heart and take you off the heart-lung machine.
• Place catheters (tubes) around your heart to drain fluids that build up.
• Close your breastbone with stainless steel wires. It will take about 6 weeks for the bone to heal. The wires will stay inside your body.

You may have a temporary pacemaker connected to your heart until your natural heart rhythm returns.

Your surgeon may also perform coronary artery bypass surgery at the same time, if needed.

This surgery may take 3 - 6 hours.

Why the Procedure Is Performed:

You may need surgery if your mitral valve does not work properly.

• A mitral valve that does not close all the way will allow blood to leak back into the left atria. This is called mitral regurgitation.
• A mitral valve that does not open fully will restrict blood flow. This is called mitral stenosis.
• A valve defect that you have had since birth is called mitral valve prolapse.

You may need open-heart valve surgery for these reasons:

• Changes in your mitral valve are causing major heart symptoms, such as angina (chest pain), shortness of breath, fainting spells (syncope), or heart failure.
• Tests show that the changes in your mitral valve are beginning to seriously affect your heart function.
• Your doctor may want to replace or repair your mitral valve at the same time as you are having open-heart surgery for another reason.
• Your heart valve has been damaged by endocarditis (infection of the heart valve).
• You have received a new heart valve in the past, and it is not working well, or you have other problems such as blood clots, infection, or bleeding.