The mitral valve replacement is conducted to replace a patient's native mitral valve, which is one of the main heart valves that allows oxygenated blood to flow from the left atrium (cavity that receives oxygenated blood from the lungs) to the left ventricle (which pumps blood to the aorta and all of the body's vital organs). When this valve is defective, it can become stenotic (the flaps become calcified and rigid, which prevents them from opening and obstructs blood flow) or regurgitant (the flaps are unable to hold back blood when closed either because of a tear in a flap or in a tendon cord that holds back the flap or because the heart has enlarged and deformed the valve, thereby preventing the flaps from fitting together).
Patients are admitted the night before or the morning of the procedure, which lasts 2 to 3 hours. The hospital stay is from 5 to 7 days and subsequent recovery time is approximately 3 months.
The MHI will contact surgical patients at home to plan a pre-admission meeting. If you are unable to attend one of these meetings, you can still get a lot of useful information about your procedure in the MHI's Heart Surgery: Patient's Handbook. If you have concerns before the surgery, you can contact the nurse working with your surgeon at 514-376-3330, extension 4062.
For this procedure, patients must be hospitalized in the Surgical Unit the night before the procedure or must arrive early the morning of the operation. The required exams are as follows: blood work and biochemical analysis, coronary angiography, chest X-ray, cardiac ultrasound and, if required, cardiac CT scan.
On the day of the surgery:
• You must be in a fasting state as of midnight the night before.
• A member of the care team will shave the required areas of the body.
• After being shaved, patients must wash with a disinfectant soap and put on a new hospital gown.
• The nurse will give patients their normal medication as well as medication to help them relax. The nurse applies a nasal cannula to administer oxygen.
• A patient service associate takes the patient to the operating room, where a specialist administers anesthesia.
This surgery lasts 2 to 3 hours, and patients are put under general anesthesia and on heart-lung bypass. The patient will have to stay in intensive care and then on the surgery floor for 5 to 7 days. A valve repair generally involves sewing an artificial ring around the valve. Long-term anticoagulant therapy (Coumadin®) is generally not required.
After the surgery, patients are transferred to intensive care for 24 to 48 hours. Visits to intensive care are limited to one person for 5 minutes on the day of the surgery and for 15 minutes on the hour starting from 11:00 a.m. the next day. After this period, patients are then transferred to the Surgery Unit for 4 to 5 days. In this unit, patients can receive visitors during regular visiting hours.
Patients normally see the surgeon 2 to 3 months after the procedure and are then followed by their family doctor or cardiologist. The main side effects are fatigue and shortness of breath, which will gradually disappear with exercise and a return to normal activities. Patients generally return to work after 3 months of recovery.