What is mitral valve replacement surgery?

Mitral valve replacement is most often done as an open-heart surgery. Minimally invasive types of surgery may be another option. The damaged mitral valve is removed and replaced with a new heart valve. The damaged valve is cut out. Then the new valve is sewn in place. The new valve may be mechanical or made of animal tissue. You and your doctor can decide before surgery which type of valve is best for you.

The mitral valve opens and closes to keep blood flowing in the proper direction through your heart. When the mitral valve does not close properly, it's called mitral valve regurgitation. If the valve is very tight and narrow, it's called mitral valve stenosis. In both of these cases, blood does not flow through the heart the right way.

During valve surgery, you are given general anesthesia. In an open-chest surgery, the doctor will make a cut in the skin over your breastbone (sternum). This cut is called an incision. Then the doctor will cut through your sternum to reach your heart. In a less invasive surgery, your doctor may make a smaller cut between your ribs. Your sternum isn't cut.

The doctor will likely connect you to a heart-lung bypass machine. It adds oxygen to your blood and moves the blood through your body. This machine will allow the doctor to stop your heartbeat while working on your heart.

After replacing your mitral valve, the doctor will restart your heartbeat. Then the doctor may use wire to put your sternum back together. Your incision will be closed with stitches or staples. The wire will stay in your chest. The incision will leave a scar that will fade with time.

You may stay in the hospital for a few days after surgery.

What happens on the day of surgery?

• 
  Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• 
  Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take about 3 to 5 hours.

After surgery

• You will go to the intensive care unit (ICU) right after surgery. You will probably stay in the ICU for 1 or 2 days before you go to your regular hospital room.
• You will have a breathing tube down your throat. This is usually removed within 6 hours after surgery. You will not be able to talk or drink liquids while the tube is in your throat. After the tube is removed, your throat will feel dry and scratchy. Your nurse will tell you when it is safe to drink liquids again.
• As you wake up in the ICU, the nurse will check to be sure you are stable and comfortable. It is important for you to tell your doctor and nurse how you feel and ask questions about any concerns you may have.
• You will have a thin plastic tube in a vein in your neck. This tube is called a catheter. It is used to keep track of how well your heart is working. This is usually removed in 1 to 3 days.
• You will also have a catheter in an artery in your arm. It is used to check your blood pressure and take blood samples.
• You will have chest tubes to drain fluid and blood after surgery. The fluid and extra blood are normal. They usually last for only a few days. The chest tubes are usually removed in 1 or 2 days.
• You will have several thin wires coming out of your chest near your incision. These wires can help keep your heartbeat steady after surgery. They will be removed before you go home.
• You will have a tube that drains urine from your bladder. This is called a urinary catheter. It is usually removed within 1 day.
• You may have a thin plastic tube in your nose that goes down the back of your throat into your stomach. It will drain stomach juices. It is usually removed in the days after surgery.