Mitral valve replacement is a heart surgery to give you a new mitral valve when your current one can’t be repaired. Your new valve will be either mechanical or biological. This surgery can relieve symptoms of mitral valve disease and prevent further damage to your heart. Talk with your provider about the benefits and risks of valve replacement.
Mitral valve replacement is a treatment option for people who have mitral valve disease. It involves surgery to give you a new mitral valve.
Your mitral valve is the passageway between your left atrium and left ventricle. These two left-sided chambers of your heart hold oxygen-rich blood. This blood travels from your lungs into your left atrium. Then, the blood passes through your mitral valve into your left ventricle. Your left ventricle has the important job of pumping it out to the rest of your body through your aorta.
If you have mitral valve disease, it’s harder for your valve to get this job done. This puts a strain on the left side of your heart. Over time, this can lead to heart and lung damage.
Sometimes, mitral valve repair can fix problems with your valve so you don’t need it replaced. But if your valve is severely damaged, you may need a new one.
Like all heart surgeries, mitral valve replacement comes with risks. But if your provider recommends this surgery, it means your valve disease is getting worse and you’re at risk for serious complications. It also means your valve can’t be repaired.
Some people have mitral valve replacement at the same time as other heart procedures. These include:
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Usually, mitral valve replacement involves open-heart surgery. However, some people are candidates for Transcatheter Mitral Valve Repair or Replacement (TMVR). This is a minimally invasive procedure that treats your valve from inside your body. TMVR allows you to avoid open-heart surgery. Your provider will let you know if this is an option for you.
Mitral valve replacement treats the following conditions:
Degenerative mitral valve prolapse is a common cause of valve surgery. This means your valve flaps (leaflets) break down over the years, leading to mitral regurgitation (leakiness). This leakiness may start out mild. But if it gets worse over time, you may need repair or replacement.
Surgeons will try to repair your valve, rather than replace it, whenever possible. However, if repair surgery has a low chance of success, then your surgeon will recommend valve replacement. Repair might not be successful if:
Talk with your provider about your options. It’s a good idea to go to a high-volume hospital (where surgeons perform many valve surgeries every day) for evaluation. Surgeons at these hospitals are experienced in evaluating valve anatomy. They’re highly skilled at deciding if repair or replacement would be better for you.
There are two types of replacement valves:
In general, providers use the following age-related guidelines as a starting point for deciding which valve you need:
These guidelines take into account the pros and cons of each type of valve.
|It's very durable. A mechanical valve can last 20 to 30 years.||You need to take blood-thinners (anticoagulants) for the rest of your life to reduce your risk of blood clots. Clots are more likely to form on mechanical valves than biological ones.|
|It reduces the chances of needing another valve surgery.||You may hear a subtle clicking sound as the valve works.|
|It's very durable. A mechanical valve can last 20 to 30 years.|
|You need to take blood-thinners (anticoagulants) for the rest of your life to reduce your risk of blood clots. Clots are more likely to form on mechanical valves than biological ones.|
|It reduces the chances of needing another valve surgery.|
|You may hear a subtle clicking sound as the valve works.|
The use of blood thinners is the drawback most people talk about. Ask your provider what long-term anticoagulation therapy involves and whether it’s safe for you. The requirement to use blood thinners can be risky for some people. These include people who:
Plus, some people may not want to take blood thinners for other reasons. So, if this is a concern for you, a biological valve may be a better option.
|You won’t need to take blood-thinners for the rest of your life (unless you need them for another medical condition).||It’s not as durable as a mechanical valve.|
|You have a lower risk of blood clots.||You’ll likely need another valve replacement surgery in about 10 to 15 years.|
|You won’t need to take blood-thinners for the rest of your life (unless you need them for another medical condition).|
|It’s not as durable as a mechanical valve.|
|You have a lower risk of blood clots.|
|You’ll likely need another valve replacement surgery in about 10 to 15 years.|
You may be wondering which type of valve is better for you. It’s a big decision. And it’s important to weigh the pros and cons of each. Surgeons recognize that each person will have their own preferences and concerns. Don’t hesitate to share your thoughts and preferences with your provider.
Heart valve surgery is the second most common heart surgery in the U.S.
In the U.S., about 90,000 people have one of their heart valves replaced each year. Around the world, this number is about 280,000. The most commonly replaced valves are the mitral valve and the aortic valve.
Your provider will give you specific instructions for how to prepare for your surgery. In general, you’ll need to:
Your provider may also give you medications to treat certain conditions before your surgery. These conditions include:
As your surgery day approaches, you should also prepare for your return home. For example, it’s important to:
During mitral valve replacement, your surgeon will remove your damaged valve and put a new one in its place. Throughout the surgery, your care team will use transesophageal echocardiography. This imaging technology guides their work and helps them confirm surgery success.
Mitral valve replacement surgery is complex and requires a careful surgical technique.
Your surgery will follow these steps.
Your surgery will include additional steps if you’re having other procedures (like CABG) done at the same time.
Mitral valve replacement generally takes two to four hours.
Most people need to spend about a week in the hospital after having valve surgery. After your surgery, you can expect to:
The advantages of mitral valve replacement include:
Complications of valve surgery include:
These complications may happen soon after your surgery or down the road. Talk with your provider about all possible complications and how to lower your risk.
Recovery from valve repair surgery usually takes four to eight weeks. Some people may need more time.
Several factors impact your recovery. These include:
Don’t push yourself to recover within a certain time frame. Everyone is different. Let your body rest, and accept help from others as you heal.
Your provider will tell you when it’s safe for you to:
About 93% to 98% of people survive mitral valve replacement surgery. The risks go up as you get older. About 91% of people over age 65 survive this surgery.
About 50% to 60% of people live at least 10 years after their mitral valve replacement. This is true whether they receive a biological valve or a mechanical one.
Your life expectancy after mitral valve replacement depends on many factors. As with any surgery, your age and overall health play a role. Factors related to the surgery itself include:
Your long-term survival is better if:
Talk with your provider about your individual situation and how long you can expect to live after your valve replacement. No provider can predict the exact number of years. But they’ll be able to assess your personal risks and give you a realistic picture of your outlook.
Your provider will tell you when you need to return for follow-up appointments. It’s important to keep these appointments so your provider can check how your new valve is working.
As you recover, stay aware of how you’re feeling. Call your provider right away if you have any signs or symptoms of complications. These include:
If you’re taking blood thinners, you should call your provider if you:
Don’t hesitate to call your provider for any reason. It’s important to share how you’re feeling, even if you think everything’s probably fine. Your provider will know if a symptom that seems “minor” is in fact something serious.
A note from Cleveland Clinic
Mitral valve replacement surgery is a major life event. If you just learned you need a new mitral valve, you may feel nervous or worried about what comes next. This is the time to learn as much as you can about your condition and treatment options, including both the benefits and the risks. Talk with your provider about why you need replacement rather than repair, and what type of replacement valve is better for you.
It’s important to seek care at a high-volume hospital where valve surgeries are performed every day. Highly experienced cardiac surgeons have the skills and training to minimize your risks and help get you on the road to recovery.
Last reviewed by a Cleveland Clinic medical professional on 05/02/2022.
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