Open Mitral Valve Repair

Open Mitral Valve Repair: Understanding the Procedure, Risks, and Aftercare

Introduction

Open mitral valve repair is a surgical procedure aimed at addressing issues with the mitral valve, located between the upper chamber (atrium) and the lower chamber (ventricle) on the left side of the heart. The mitral valve comprises two flaps (leaflets) that facilitate blood flow from the atrium to the ventricle, allowing blood to move in one direction. This surgery becomes necessary when the mitral valve does not function properly, leading to insufficient opening, incomplete closure, or other problems. Open mitral valve repair may also be recommended in cases of valve infection, weak heart muscle, or symptomatic leakage.

The Procedure

“Open” in open mitral valve repair refers to the use of a large incision in the chest to access the heart. The surgery may involve:

1. Repairing the valve by removing tissue, fixing holes or tears, replacing cords supporting the valve, separating fused flaps, or reconnecting flaps.
2. Replacing the valve with a new one, if repair is not possible during surgery.

Risks and Complications

While open mitral valve repair is generally safe, complications may arise, including:

1. Infection.
2. Bleeding.
3. Allergic reactions to medications.
4. Damage to nearby structures or organs.
5. Blood clots.
6. Breathing problems.
7. Heart attack.
8. Stroke.
9. Kidney problems.
10. Irregular heartbeat.
11. Failure of a ring or device used for valve repair.

Before the Procedure

Before undergoing open mitral valve repair, patients should discuss the following with their healthcare provider:

1. Eating and drinking restrictions.
2. Medication management, especially for diabetes and blood thinners.
3. Use of aspirin and ibuprofen (unless advised by the healthcare provider).
4. Over-the-counter medicines, vitamins, herbs, and supplements.

During the Procedure

During the procedure:

1. An IV will be inserted into a vein.
2. Medications such as sedatives or general anesthetics may be administered.
3. A breathing tube may be inserted to support breathing.
4. An incision will be made in the chest, over the heart, through the breastbone.
5. Muscles will be moved to access the heart.
6. The heart may be stopped with medication, and a heart-lung machine may be used to maintain blood flow and lung function.
7. The mitral valve will be repaired as needed, and a ring or device may be used for reshaping, repairing holes or tears, or fixing the flaps.
8. Electric shocks may be used to restart the heart.
9. Tubes may be placed to drain fluids, and a catheter may be inserted to drain urine.
10. The incision will be closed with glue, and a dressing may be applied.

After the Procedure

After the procedure:

1. Vital signs will be monitored until discharge.
2. Pain relief medications will be provided as needed.
3. Fluids and medications may be administered through an IV.
4. Breathing support may continue through a tube and ventilator.
5. Oxygen may be provided through nasal prongs.
6. Drainage tubes may remain in place.
7. A catheter may be used for urine drainage.

Conclusion

Open mitral valve repair is a surgical intervention to address mitral valve problems, and it involves making an incision in the chest. Understanding the procedure, risks, and aftercare instructions from the healthcare provider is essential for a successful recovery. Patients undergoing open mitral valve repair should follow their healthcare provider’s guidance and seek clarification for any questions or concerns they may have.