The mitral valve is one of the four major valves in the heart. It helps the blood flow through your body.

“Stress is put on your heart when this valve isn’t working correctly. It makes it difficult for your blood to clot.”

Medicine or surgical repairs can be used to fix your mitral valve. These options are not as aggressive.

In severe cases, the valve will need to be replaced completely. This is a procedure to replace a mitral valve.

Problems with your mitral valve are called mitral valve disease. For some people, mitral valve disease is silent and there are no symptoms until the damage is severe. When symptoms occur, they include shortness of breath, lightheadedness, and a rapid heartbeat.

There are two types of valve disease.

  • Mitral valve stenosis. In this condition, your mitral valve can’t open all the way. This results in less blood flowing through the chambers of your heart.
  • Mitral valve regurgitation. This means that your mitral valve is leaking blood. In this condition, some of the blood that should be traveling through your heart leaks backward instead of forward.

There are several factors that can lead to mitral valve disease. The condition is usually caused by normal aging and the mitral valve wearing out. Certain health conditions can cause mitral valve disease.

Your medical team will help you prepare. Discuss the type of valve you will be receiving with your doctor. You and your doctor can decide which type of valve is best for you. There are two options for a replacement mitral valve.

  • Biological valves are made from human, cow, or pig heart tissue. They don’t last as long as mechanical valves.
  • Mechanical valves are human-made. They are long lasting but have a higher risk of infection. You’ll need to take blood thinners for the rest of your life if you receive a mechanical valve.

You might need to take some tests a week or two before your surgery. The tests will help your medical team. The tests might include:

You will have specific instructions in the days before your surgery. Your doctor will give you instructions before your procedure.

  • Pack a bag of things.
  • Talk to your doctor about when to stop taking blood-thinning medications and if you should take an injection instead.
  • “Don’t drink or eat after midnight the night before your surgery.”
  • Before surgery, remove nail polish, jewelry, contact lens, and dentures.

Open heart surgery is a procedure that involves cutting through your breastbone. There are also minimally-invagant options.

Open heart surgery

There are several steps to a mitral valve replacement procedure. You’ll first be given anesthesia which will put you to sleep and ensure you don’t feel any pain during the procedure. Once you’re under anesthesia, your surgical team will:

  1. Make an opening in the middle of your chest.
  2. To access your heart, separate your breastbone.
  3. Attach you to a machine that will act as a mechanical heart and lungs during the operation.
  4. Remove your mitral valve.
  5. Carefully place your new valve.
  6. The machine that lungs the heart.
  7. Rewired your breastbone.
  8. Attach your skin back together.

The surgery for a mitral valve is lengthy. Once your surgery is over, you will be moved to a recovery room. The nurses and other medical staff in the recovery room will watch you as you wake up from anesthesia and then move you to the general hospital floor.

Minimally invasive options

Transcatheter mitral valve replacement (TMVR) is a way to replace your valve without open heart surgery. Instead of making a large incision, your surgeon will insert a thin tube into a vein in your groin. The new valve is then guided through the tube to replace the old valve.

As of 2021, there were nine different TMVR devices being studied. have yet been approved by the FDA.

Robot-assisted mitral valve surgery also eliminates the need for a large incision in your chest. Instead, several small incisions are made. Surgeons control the robotic device as it uses small instruments to perform the surgery.

Robot-assisted surgery typically costs more than open surgery. But the higher cost is mitigated somewhat by a shorter hospital stay after surgery.

“A major surgery such as mitral valve replacement isn’t right for everyone. There are possible risks.”

People who have mitral valve replacement surgery have a higher risk of having a problem. This includes people who are not related to each other.

  • have a weakened immune system or frequently get infections
  • Have a lot of chronic health conditions.
  • Have a different heart condition.
  • Have lung health concerns?
  • have obesity
  • There is smoke.
  • Have a problem with the kidneys.
  • Have a heart problem..
  • Have you had a stroke?

People who are older or have a bad health may benefit from other treatment options.

You can discuss your mitral valve disease with your doctor, as well as your risk factors, if replacement is the best choice for you. They can help you make a decision.

People with mitral valve disease can benefit from valve repair. It can help you feel better after surgery.

Your surgery might be followed by attending a program called cardiac rehabilitation. Cardiac rehab programs are designed to help you recover from your surgery and will teach you exercises and other tips to make the most of your new mitral valve.

When you have a replacement mitral valve, it is important to adopt a healthy lifestyle. Common parts of a healthy lifestyle include: Your doctor can help you develop what that means for you, but you should also be aware of the following.

Changes to your medication might be a result of a mitral valve replacement. If you received a mechanical valve replacement, you will need to take blood thinners daily.

You’ll likely need to take antibiotics before any dental procedures, including cleanings. These procedures might expose you to an infection that can lead to endocarditis.

You will have regular checks to make sure your replacement valve is working. If you received a biological valve, it may need to be replaced again.

A mitral valve replacement is one option for treating mitral valve disease. Other options are often preferred because they are less intrusive and can preserve your original heart valve. There are alternatives to mitral valve replacement.

  • Medications such as blood thinners, blood pressure-reducing medications, and diuretics can all be prescribed to help treat mitral valve disease. These medications can’t repair your mitral valve, but they can improve how your heart works and how your blood circulates.
  • MitraClip is a minimally invasive procedure that can help you avoid surgery. Doctors can insert a clip through a vein in your leg and then carefully guide it up to your arteries and heart. They can then use the clip to fix leaks in your mitral valve.
  • Mitral repair surgery is done when your mitral valve isn’t working correctly but is still healthy enough to be fixed. In repair surgeries, surgeons can fix structural problems so that your valve functions better.

Does Medicare cover mitral valve replacement?

If it is medically necessary, Medicare may cover the open heart mitral valve replacement. If you have a mitral valve disease, your doctor will need to send proof of previous treatment attempts in order for Medicare to cover it.

The FDA does not approve the TVMR, so it is not covered by Medicare.

What is the recovery time for a mitral valve replacement?

You will spend about 5 days in the hospital after the mitral valve replacement. It will take several weeks to recover from surgery.

You will be tired and sore in the first few weeks after surgery, but you will feel better the more you eat. Your doctor will let you know when it is safe to resume your normal activities, and you will have pain medications prescribed to help you manage your recovery.

Will I need a pacemaker after mitral valve replacement?

Some people do receive mitral valve replacement surgery and need a pacemaker at a later time, but this isn’t common. For most people, mitral valve replacement surgery improves their quality of life and eliminates symptoms, such as a racing heart that might be associated with the need for a pacemaker. Talk to your doctor if you are concerned you might need a pacemaker in the future.

A serious procedure that is done to correct problems with the mitral valve is mitral valve replacement surgery.

“Sometimes doctors can correct problems with your mitral valve with less intrusive procedures. Replacement surgery can improve your quality of life if they can’t.”

You can learn a lot from attending a cardiac rehab program after surgery.