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Cardiac Valve Replacement / Repair ( AVR/ MVR)

MVR (Mitral Valve Replacement) is a cardiac surgical procedure performed to replace a mitral valve that is not functioning properly. The mitral valve is located between the left heart chambers, i.e., left atrium and left ventricle. The valve replacement is an open-heart surgery; in a few cases, a catheter procedure or minimally invasive surgery may be possible.

Indications for Mitral Valve Replacement

Mitral Valve Regurgitation: When a mitral valve does not close properly and allows blood to leak back into the left atria.
Mitral Valve Stenosis: Mitral Valve Stenosis is a condition when a mitral valve does not open fully, results in restricting the blood flow. It may be the result of an infection (infectious endocarditis).
Severe mitral valve prolapse
Signs and Symptoms of Mitral Valve Disease

Signs and symptoms of mitral valve disease are

Heart murmur on auscultation
Breathlessness
Easy fatigue
Irregular heartbeat
Swelling in ankles and feet

Tests and Diagnosis for Mitral Valve Replacement

Physical Examination: The physician will use auscultation to hear a heart murmur of the patient.
Echocardiography: An echocardiogram helps the doctor to understand the mitral valve and its working.
Transesophageal Echocardiogram
Electrocardiogram (ECG): An ECG can detect abnormal heart rhythms, enlarged chambers of heart, and heart disease.
Chest X-ray
Stress Tests
Cardiac MRI
Mitral Valve Replacement Surgery

Open Surgery

Before Procedure

Standard blood tests are done to check fitness for surgery.
The patient is counselled about the procedure and after care.
During Procedure

An open surgery procedure is performed under general anesthesia.
An IV line and breathing tube are inserted.
An incision is made in the middle of the chest, the surgeon separates the sternum to expose pericardium, then opens pericardium to reach to the heart.
Connects the heart to a heart-lung machine, tubes are used to reroute the blood into a machine that takes over the function of lung and heart during the operation.
The heart is temporarily stopped and blood removed; the valve is still and allows the surgeon to see it.
The Cardiologist makes an incision around the edge of the damaged valve and replaces it.

After Procedure

After valve replacement, the patient usually needs to stay in the hospital for about a week. For the initial days, he/she will be kept in the ICU (Intensive Care Unit.)
The activity of the patient’s heart, lungs and body functions will be closely monitored; the ventilator will be placed until he/she is able to breathe.
Draining tubes are inserted from the chest to drain away any build-up of fluid or blood.
Pacing wires, if necessary, will be inserted near the chest drains to control the heart rate of the patient.
The patient is advised to follow a cardiac rehabilitation program.
The patient is advised to avoid sudden strains, strenuous exercise and heavy lifting for at least three months.
The patient will be able to perform usual activities after 4-6 weeks.
The patient is advised to report to the physician if any warning signs of infection are found.
The patient should consult the doctor regularly to check the efficiency of the heart valve.
If the patient has a mechanical heart valve, then anticoagulant medicine is necessary to help prevent clots.
Minimally Invasive Mitral Valve Surgery

In endoscopic surgery, the surgeon makes 1 to 4 small holes in the patient’s chest. Surgery is done through the cuts using special surgical tools and a camera.

Robotic Assisted Valve Surgery

The surgeon makes 2 to 4 tiny cuts in the patient’s chest. A special computer is used by the surgeon to control robotic arms during the surgery.