Mitral valve surgery

How to prepare for mitral valve surgery

Your consultant will tell you everything you need to do to prepare for your mitral valve surgery. Instructions on how to prepare will also be in your appointment letter.

If there’s anything you’re not sure about, or if you have any questions, please contact us for advice.

Pre-operative assessment

Around a week or two before your mitral valve surgery, you may need to attend the hospital for a pre-operative assessment to make sure you are fit for surgery. Take any medication you take regularly with you to your appointment. At the preoperative assessment, we will check your weight and blood pressure and order tests such as a blood test, chest X-ray and electrocardiogram (ECG) to evaluate your general health.

Optimise your general health

It's important to be in the best possible health before your mitral valve surgery as this will allow your procedure to go as smoothly as possible, speed up your recovery and reduce the risk of any complications after your surgery.

To ensure you are as healthy as possible before your surgery:

• Stop smoking at least eight weeks before your procedure. Smoking increases the risk of complications such as breathing difficulties and infection and can delay wound healing. Talk to your consultant about quitting smoking before your surgery.  
• Follow a healthy, nutritious diet
• Take regular exercise
• Avoid alcohol for a few days before your mitral valve surgery. Alcohol thins your blood and can increase the risk of bleeding during your operation. 

Prepare your home

You can help make your recovery easier by making some preparations in advance. These include:

• Stock up on food and prepare meals in advance that you can freeze and heat up during your recovery
• Arrange for child and pet care if needed 
• Arrange for someone to help you with household chores such as shopping, cooking, laundry and cleaning during your recovery 
• Keep things you use regularly such as your glasses, medications, useful telephone numbers, and the TV remote control within easy reach 

Regular medications

Your consultant may tell you to stop taking certain medications, such as blood thinners for a few days before your surgery. This is to minimise the risk of bleeding during and after your procedure. 

On the day of your surgery

On the day of your surgery, take a shower before you arrive at the hospital. Do not apply any products to your skin such as lotions, creams, makeup or perfume. Do not wear nail varnish and leave any valuables and jewellery at home.

You’ll need to spend a few days in hospital after your mitral valve surgery, so pack a bag with loose, comfortable clothes that fasten at the front and are easy to get on and off. Take some things to pass the time like books, magazines, games, or knitting.

You will not be able to eat or drink anything from midnight on the day of your mitral valve surgery.

What happens during mitral valve surgery?

Before your surgery, you’ll need to sign a consent form to say that you agree to have the procedure and are aware of what it entails and the possible risks and complications of the surgery.

Mitral valve surgery is performed under general anaesthetic, meaning you’ll be asleep for the procedure.

Types of mitral valve surgery

There are two main types of mitral valve surgery; mitral valve replacement, and mitral valve repair.

• Mitral valve replacement: Your consultant replaces your mitral valve using either a valve made from animal tissue (a bioprosthetic valve) or a mechanical valve. 
• Mitral valve repair: Your consultant repairs your damaged mitral valve by bringing the flaps of your valve closer together and reducing the backflow of blood through your heart. 

How is mitral valve surgery performed?

Mitral valve surgery can be performed as open heart surgery, minimally invasive surgery, or catheter-based mitral valve surgery. You will be connected to a heart-lung bypass machine to temporarily take over the function of your heart and lungs during open and minimally invasive surgery.

Mitral valve surgery normally takes between two and four hours.

Open-heart surgery

During open-heart surgery, your consultant makes a large incision (cut) in the middle of your chest to access your heart and carry out the procedure. 

Minimally invasive heart surgery

Minimally invasive surgery uses much smaller incisions than open-heart surgery and has a faster recovery time, less pain, a shorter hospital stay and a lower risk of complications. Types of minimally invasive mitral valve surgery include:

• Robot-assisted heart surgery: During this type of minimally invasive procedure, your consultant uses robotic arms to repair or replace your damaged mitral valve through small incisions in your chest
• Annuloplasty: This type of surgery can be performed as open or minimally invasive surgery. It involves tightening, reshaping or reinforcing the ring (annulus) around your damaged mitral valve. It may be performed at the same time as other procedures to repair your mitral valve. 

Catheter-based mitral valve surgery

This type of minimally invasive surgery is where a thin flexible tube called a catheter is inserted into your leg or chest and guided through a blood vessel to your heart. Types of catheter-based surgery include:

• Transcatheter mitral valve repair (TMVr): Your consultant uses a clip inserted through the catheter to join your damaged mitral valve's flaps and reduce the amount of blood that flows backwards through your mitral valve
• Transcatheter mitral valve replacement (TMVR): Your mitral valve is replaced through a catheter
• Percutaneous valvuloplasty (balloon valvuloplasty): A catheter with a balloon attached is inserted through an artery in your groin and inflated to stretch a blocked or narrowed mitral valve. 

Recovering from mitral valve surgery

Recovering from any type of surgery is a gradual process that is different for everyone. Recovering from mitral valve surgery depends on several factors including your age, general health, the type of procedure you had and your individual recovery process. You can help your recovery to go more smoothly by being as well informed as possible about your surgery and recovery and following your consultant’s post-operative instructions carefully. Call the hospital if you have any questions or concerns. 

After your mitral valve surgery, you may be taken to the intensive care unit (ICU) or high dependency unit (HDU) where you’ll be monitored closely for the first day or two after your surgery. You may be connected to a breathing machine to help you breathe for a while after your surgery as well as other machines to monitor your heart and other organs. When your condition is stable, you’ll be able to go to your room.

You’ll be given regular pain medication to help with any pain or discomfort after your mitral valve surgery.

It’s important to get out of bed and move around as soon as possible after your surgery as this will reduce the risk of developing complications such as a chest infection or blood clots. A member of our physiotherapy team will help you out of bed and teach you some exercises to do during your recovery. You’ll also be given compression stockings to wear after your surgery to help prevent blood clots in your legs.

Your healthcare team will give you instructions on how to care for your surgical wound before you go home. You will also be given a follow-up appointment to check your progress and monitor you during your recovery.

Avoid strenuous activity, heavy lifting and sex until your consultant tells you it’s safe after your mitral valve surgery.

It’s normal to feel quite tired for a while after your mitral valve surgery. Take things at your own pace and listen to your body during your recovery. Gradually increase your activity level day by day and rest when you feel tired.

How many nights will I need to stay in hospital?

You can expect to spend three to five days in hospital after minimally invasive mitral valve surgery and around a week after open surgery.

Will I be able to drive home?

You will not be able to drive yourself home from the hospital after you are discharged. Please arrange for someone to collect you.

How soon can I go back to work?

How soon you can return to work after your mitral valve surgery will depend on the type of surgery you had and the job you do. You can expect to take at least six weeks off work if your job is sedentary, such as an office job. If your job is very active or strenuous, you may need to take around three months off work.

When can I drive?

You won't be able to drive until you can safely control your vehicle and perform an emergency stop. This is normally at least six weeks after your mitral valve surgery. Don’t drive while taking strong painkillers or other medications that can affect your concentration and impair your reaction times. Get the all-clear from your consultant and inform your insurance company of your surgery before driving after your mitral valve surgery.

When will I be back to normal?

You can expect to return to most normal daily activities around six weeks after minimally invasive mitral valve surgery. Full recovery from open surgery takes longer and may be up to three months.

After your mitral valve surgery, you will need to have regular checkups to make sure your new or repaired valve is working properly. Your consultant will also advise you on some lifestyle changes you can implement after your surgery to improve your overall health and the health of your heart. This may include:

• Not smoking 
• Losing weight (if needed) and maintaining a healthy weight
• Following a healthy, nutritious diet 
• Taking regular exercise
• Keeping your cholesterol, blood pressure and blood sugar within normal limits 
• Reducing stress
• Getting plenty of sleep

Potential risks and complications of mitral valve surgery

Mitral valve surgery is a generally safe procedure, but as with any type of surgery, there is a small risk of complications. 

Your consultant will explain all the possible risks and complications of mitral valve surgery before your procedure and answer any questions you may have. It’s important that you are fully informed about any possible risks and complications before your procedure and are able to make an informed decision.

Possible complications of any type of surgery may include:

• Adverse reactions to the anaesthetic
• Bleeding 
• Blood clots in the legs or lungs
• Wound infection
• Damage to nearby structures
• Chest infection

In addition, possible complications of mitral valve surgery may include: 

• Infection of the valve
• Arrhythmias (may need to be corrected by implanting a pacemaker)
• Failure of the replacement valve
• Stroke
• Endocarditis: Infection of the lining of the heart

Why choose Circle Health Group for mitral valve surgery?

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more book your appointment online today or call a member of our team directly on 0808 189 5499.

Clinical review and sources

1. Mitral valve problems NHS
2. Mitral valve surgery-minimally invasive Medline Plus 
3. Heart valve replacement surgery British Heart Foundation 
4. Mitral valve repair and replacement Guy’s and St Thomas’ Specialist Care