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Mitral valve surgery - minimally invasive

This is a surgery done to repair or replace the valve.

The blood which comes from the lungs enters into the left atrium of the heart and then, crosses into the left ventricle. The valve between the two chambers, known as the mitral valve makes sure that the blood keeps moving forward, and when the mitral valve is hardened (calcified),then it prevents the blood from moving forward, if the mitral valve is loose then the blood tends to flow backwards, due to these conditions mitral valve surgery is required.

Minimally invasive mitral valve surgery is done through a smaller surgical incision, for open surgery.


The physician will administer anaesthesia, before the surgery so that you don't feel the pain. There are different ways to perform minimally invasive mitral valve surgery.

  • The surgeon will make an 2-3 inches cut in the right part of the chest near the breastbone(sternum).The surgeon divides the muscles so that he can reach your heart, then he makes a small cut on the left side of the heart so that he can repair or replace the mitral valve.
  • If an endoscopic is done then , the surgeon makes four small holes in the chest, the surgeon then uses a special instrument , which is known as a camera to conduct the surgery.
  • If a robotic -assisted valve surgery is done , then the surgeon makes 2-4 tiny cuts ((about ½ to ¾ inch) in the chest, the surgeon uses a special computer to control the robotic arms during the surgery, and the surgeon notices a three-dimensional view of the heart and mitral valve on the computer, and this method is done meticulously. In this procedure you may not need to be on a heart-lung machine, for these types of surgery, but if not then the heart rate can be slower by medication, or a mechanical device.

If the surgeon can repair the mitral valve then the conditions are:

  • Ring annuloplasty -- The surgeon sews the valve with a help of a ring of metal or cloth or tissue around the valve.
  • Valve repair - The surgeons repairs, trims, and shapes and rebuilds both the leaflets of the valve,the leaflets are known as flaps which help to open and close the valve.

If there is extensive damage to the mitral valve, you will need a new valve, this is called replacement surgery, and your surgeon will remove the mitral valve and sew a new one into place, there are two main types of new valves, mechanical & Biological, as explained above.

This surgery may take up to 4 hours, this surgery can be done through the groin artery with no cuts in the chest, where the doctor sends a catheter( tube) with a balloon attached at the end of it, the balloon stretches the opening of the valve, and this procedure is called percutaneous valvuoplasty.

A mitral minimally invasive procedure has many benefits, there is less pain and blood loss and risk of infection, the advantage is that you recover faster than you would with an open heart surgery.

Please remember that patients who are weaker and are very sick, and cannot stomach anaesthesia only then a percutaneous valvoplasty is done, and the results are not long lasting.


Risks for any surgery are:

  • Blood clots that travel from the legs to the lungs

    Loss of blood, breathing problems, Infection in the lung, bladder , chest or heart valves,

    Allergies related to medication & reactions

    With minimally invasive mitral surgery the risks are fewer than, open heart surgery, there are possible risks however:

  • The organs can be damaged, including nerves and bones

    • Heart attack/stroke
    • Infection of the valve
    • Irregular heartbeat, which must be treated with medication or a pacemaker
    • Kidney failure
    • Wounds that do not heal

Before the Procedure

Keep your doctor & nurse informed , if you are pregnant, and the medication you are under, show the prescription to the doctor

If a blood transfusion is required, you can store blood in the blood bank during or after surgery, if the family needs to donate blood ask you surgeon.

During a 2 week period , which is before the surgery, the doctor may ask you to stop taking any medication, which may be harder for your blood to clot, these risks might caused increased bleeding during the surgery.

Certain drugs, like,aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn), that can lead to increased bleeding during surgery, also warfarin (Coumadin) or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs.

Keep your house in order when you get home from the hospital.

Before the surgery have a good shower and shampoo well, the doctor may ask you to wash your whole body with a speical soap esepeciallybelow the neck, and to scrub your chest two to three times with this soap, you can also be asked to take an antibiotic to guard against any infection.

During the days before your surgery

Check with your doctor which drugs you need to still take on the day of surgery

If you smoke you are restricted from smoking.

If you have any kind of cold or flu, or infection, or other disease like herpes or any other illness keep your doctor informed.

On the day of the surgery:

The doctor will advise not to eat or drink anything after midnight, the night before the surgery, this includes chewing gum, and using breath refreshners. If you feel thirsty rinse your mouth with water, but be careful not to swallow it.

Use the medication which the doctor advise you to take with a small sip of water.

The doctor will advise you when to arrive at the hospital.

After the Procedure/Recovery

After the surgery you would need to spend at least 2-3 days in the hospital, and you will be taken to the ICU to recover there for about 1-2 days. Nursing care will take care of you while you are in the ICU, and monitor your vital signs, including breathing.

The tubes which are inserted in your chest, as a part of procedure, will help to drain the fluid around the heart, and they usually removed after 1-3 days . A catheter will be fixed in your bladder to drain out the urine, and also have an intravenous in the vein to get the fluids.

After 3 days, in the ICU when your condition is stable, the doctor would remove you from ICU and send you to a private room, and the nurses and doctors will still keep a tab on your vital signs and monitor your heart, till they are stable and you are able to go home, you will also receive pain medication for the pain in your chest. The nursing aid will help you resume to normal activity, and the doctor encourage to a program to make your heart and body stronger.