Mitral valve replacement is a surgical procedure performed to replace a damaged mitral valve of the heart with a mechanical or biological one. Patients receive a general anesthetic and are hooked up to a heart-lung machine that performs the pumping action of a normal beating heart, because the heart itself must not be allowed to beat during the surgery. Necessary incisions are made to reach the mitral valve, which is removed and then replaced by sewing in a mechanical or biological one. The incisions are closed, after which the heart-lung machine is disconnected and the natural heart is restarted. When no complications are encountered during the surgery, the entire procedure generally is completed within five hours.
Immediately after this procedure, patients typically are placed in an intensive care unit for at least 24 hours. While some advanced medical centers offer less invasive methods for performing mitral valve replacement, surgery is the general procedure. The mitral valve, also known as the bicuspid valve, is the inlet valve located in the left ventricle, which opens from the left auricle. Mitral valve regurgitation, also called mitral incompetence or mitral insufficiency, when it is severe, might be treated by performing surgery.
Mechanical replacement involves sewing in an artificial valve made of metal and plastic. Biological replacement refers to the use of an artificial valve made of tissue taken from an animal such as a pig. That tissue is enclosed within a synthetic ring. The decision of which type to use in mitral valve replacement is determined by several factors. For example, patients who receive a mechanical valve must take anticoagulants for an indefinite period of time, so this might not be the best choice for some people, such as females of child-bearing age.
One advantage that the mechanical valves have over the biological ones is their durability, which practically eliminates the need to undergo mitral valve replacement again after it has been successfully performed once. Biological valves generally do not last as long as their mechanical counterparts, but patients who receive them do not have to take anticoagulants. People who have a damaged or artificial valve, however, are also advised to take antibiotics before medical, dental or surgical procedures because of the significant increase in the risk of very serious infections. Although mitral valve replacement might not sound like a very intense medical procedure compared to some other procedures that are performed to correct heart problems, patients might take as long as eight weeks to fully recover.