What is mitral valve disease?

Your heart is a muscle that pumps oxygen-rich blood from your lungs around your body and oxygen-poor blood from your body to your lungs.

Your mitral valve is a one-way valve that controls the flow of blood from the main collecting chamber (left atrium) into the main pumping chamber (left ventricle). The valve is made up of two leaflets (or ‘doors’) that are forced open as the atrium contracts.

Mitral valve disease is where the valve does not open properly, is narrowed (stenosis), or does not close properly (incompetence).

What are the benefits of surgery?

You should get improved breathing, less chest pain and more energy, and have a better quality of life. You should live longer with surgery.

Are there any alternatives to surgery?

Medication is the main alternative to surgery.

• Diuretics (water tablets that reduce extra fluid) to lessen the strain on your heart.
• ACE-inhibitors to make your heartbeat stronger.
• Digoxin to stabilise your heart rhythm.

Instead of open heart surgery, a leaking mitral valve may be treated by applying a clip to the valve. Certain health conditions can increase the risk of complications for people who have open heart surgery. This procedure may be more suitable in such cases.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes 3 to 4 hours.

Your surgeon will usually make a cut down the front of your chest, through your breastbone (sternum).

You will be connected to a heart-lung machine, which allows your heart to be still while your surgeon replaces or repairs the valve.

If the valve is not too damaged, your surgeon may be able to repair it.

When your surgeon has replaced or repaired the valve, your heart will take over again and you will be disconnected from the heart-lung machine.

How can I prepare myself for the operation?

Bad teeth and gums can cause infection of the lining of your heart and the new heart valve. Keep your teeth and gums as healthy as possible, and go to your dentist regularly for a check-up. You should not have the operation if you have poor dental hygiene or a dental infection.

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

General complications of any operation

• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• acute kidney injury
• bleeding
• venous thromboembolism (VTE)
• chest infection

Specific complications of this operation

• heart attack
• stroke
• infection of the replacement valve
• death

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

After the operation you will be transferred to the cardiac intensive care unit or high dependency unit for a few days, so the healthcare team can monitor you more closely. You will then go to the ward.

The drains, drips and catheter will usually be removed after 2 to 5 days.

You should be able to go home after 7 to 10 days.

The healthcare team will tell you when you can return to normal activities.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery, with no more shortness of breath or chest pain.

Summary

Mitral valve disease can cause pain, shortness of breath and eventually death. Mitral valve surgery can relieve your pain, improve your breathing and energy levels, and may help you to live longer.

IMPORTANT INFORMATION

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