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Mitral Valve Replacement: Before Your Surgery

Artificial valve in the heart

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.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
  • Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

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.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter O995 in the search box to learn more about "Mitral Valve Replacement: Before Your Surgery".

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.