During the procedure a cut (incision) about 25cm long is made in your chest to access your heart – although sometimes a smaller cut (Keyhole incision- see below) may be made. The surgeon uses a heart-lung machine (cardiopulmonary bypass machine) to take over the work of the heart and lungs whilst the mitral valve surgery is being performed.
Mitral valve repair
One of the most common disease pathologies (degenerative disease) causing the mitral valve to leak, is usually best repaired. This helps to maintain the overall structure of the mitral valve and preserve the heart function. If the valve cannot be repaired, then a replacement is the only alternative.
The operation is carried out under general anaesthetic (where you're asleep). Your surgeon will usually get to your heart through a single cut along the middle of your chest, but smaller cuts between your ribs are sometimes used - minimally invasive or 'Keyhole surgery'.
The flaps of the mitral valve are then repaired, and a supporting ring (equivalent to a doorframe) inserted. The valve is tested during the operation to ensure that it is working properly, and a TOE performed at the end of the operation, again, to ensure that the repair is working well.
Mitral valve replacement
The operation is carried out under general anaesthetic. Your surgeon will usually get to your heart through a single cut along the middle of your chest, but smaller cuts between your ribs are sometimes used - minimally invasive or 'Keyhole surgery'.
The Mitral valve is replaced with either synthetic materials (mechanical) or animal tissue (tissue). Your surgeon should discuss with you the advantages and disadvantage of each type of valve taking into account your preference.
This is usually only done if you have mitral stenosis, or you have mitral prolapse or regurgitation and are unable to have a valve repair. You will also need to take medication (Warfarin) to prevent blood clots for at least 3 months after this operation if you have had a bioprosthetic valve replacement. If you have a man-made valve, you'll need to take this medication for life.
The breastbone is put back together with steel wire until the bone heals itself in 4-6 weeks.
In some operations, not all of the breastbone needs to be cut. This is called keyhole surgery or minimally invasive surgery. This can be performed in some centres where the procedure is performed regularly. This is called a Mini-MVR and can be performed with a cut to the side of your breastbone between the ribs. The heart-lung machine (cardiopulmonary bypass machine) is still used to perform the procedure, but you may need a separate cut in your groin to help with this.