Surgery Overview
Surgery is required for severe
(MR).
Surgery
for MR is recommended when you have symptoms of
, or when your
drops below 60% and/or your left
ventricle is larger than 40 mm at rest.1
In general, surgery for
(MVP) is only done if you have
mitral valve regurgitation. Valve repair or replacement are the two types of
surgery available to treat these conditions.
Both valve repair
and replacement are typically open-heart surgeries. Minimally invasive types of
surgery may be another option. This section describes open-heart
surgery.
During valve surgery, you are given
. Surgery typically lasts about 3 to
5 hours. Your doctor makes a large incision in your chest. You are placed on a
heart-lung machine during the surgery. Blood is circulated outside of the body
and oxygen is added to it using a heart-lung (cardiopulmonary bypass) machine.
To protect the heart muscle from damage during surgery to replace the heart
valve, the heart may be cooled to slow or stop the heartbeat. The damaged
mitral valve is either repaired or removed and replaced with an artificial
() heart valve.
The decision
between repairing or replacing the valve depends on the type of damage to the
mitral valve. For instance, repair is more successful if there is limited
damage to certain areas of the mitral valve flaps (leaflets) or to the tough
fibers that control movement of the mitral valve leaflets (chordae tendineae).
But replacement is usually preferred for people who have a hard, calcified
mitral valve ring (annulus) or widespread damage to the valve and surrounding
tissue.
To repair the heart valve, the
surgeon may:
- Reshape the valve by removing excess valve
tissue.
- Add support to the valve ring by adding tissue or a
collar-shaped structure around the base of the valve.
- Attach the valve
to nearby cordlike heart tissues (chordal transposition).
Heart valve replacement surgery
involves the removal of the badly damaged valve. The valve is replaced with a
plastic or metal mechanical valve, or a bioprosthetic valve, which is usually
made from pig tissue. The damaged valve is cut out, and the new valve is sewn
into place.
People who receive a mechanical heart valve are more
likely than those who receive a bioprosthetic heart valve to develop blood
clots in the heart. The clots may break loose, travel to the brain, and cause a
. So if you have received a mechanical heart
valve to treat severe MR, you will need to take medicine for the rest of your
life to prevent clots from forming (anticoagulant medicine).