Heart Valve Repair or Replacement Surgery
Surgery is required for severe mitral valve regurgitation (MR). Surgery
for MR is recommended when the symptoms of heart failure are present and
when your ejection fraction drops below 60 percent and your left ventricle
is larger than 45 mm at rest.
Generally, surgery for mitral valve prolapse (MVP) is only done when mitral
valve regurgitation is present. Valve repair or replacement are the two
types of surgeries available to treat these conditions. Valve repair or
replacement is an open-heart surgery. You are given general anesthesia
and placed on a heart-lung machine during the surgery, which usually lasts
about 3 to 5 hours.
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). Replacement, however, is usually preferred
for people who have a hard, calcified mitral valve ring (annulus) or widespread
damage to the valve and surrounding tissue. For heart valve repair, one
of the following procedures is done: - Reshaping of the valve by removing
excess valve tissue - Adding support to the valve ring by adding tissue
or a collarlike structure around the base of the valve - Attaching the
valve to nearby heart cordlike 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.
Recovery from heart valve surgery usually involves a few days in our cardiac
intensive care unit (CICU). Full recovery from heart valve surgery can
take several months. Recovery includes healing of the surgical incision,
gradual building of physical endurance, and exercise. An exercise program
under the direction of a physical therapist or outpatient cardiac rehabilitation
specialist is usually recommended.
Once you have an artificial valve, your heart function and your life will
largely return to normal. You should feel better than before you had the
surgery if your condition was symptomatic; for example, you should no
longer experience shortness of breath and fatigue. However, if your heart
was already severely affected before your surgery, you may continue to
experience complications of heart disease. You should be able to resume
most of your normal activities, although you will have to continue to
monitor your condition. You need to watch out for blood clots and infections
so it is important that you see your doctor regularly.