Mitral Valve Replacement Procedure

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Mitral Valve Replacement Procedure

Patient will be placed under general anesthesia. An endotracheal tube will be inserted into the patientís windpipe and connected to a ventilator to assist the patientís breathing. Another probe will be inserted through the patientís esophagus. This is a TEE (trans thoracic echocardiogram) probe. TEE allows intra operative evaluation of the valve motion and detection of prosthetic valve insufficiency. It can detect any presence of thrombus as well.


Patient will be cleaned using antiseptic solution like alcoholic spirit and betadine and draped completely except exposing his chest. Routinely the chest is cut along the middle and the breastbone is sawed open. When the heart is exposed, the heart is connected to a heart lung machine. The blood is diverted through sterile plastic tubes to the heart lung machine, which oxygenates and pumps it back to the body. It is easier for the surgeon to operate on a still rather than a beating heart. An incision on the left atrium is made. The mitral valve is exposed and flushed with saline. This allows the surgeon to get a good look at the valve.


The diseased valve along with its subvalvular apparatus is cut. A portion of the posterior valve along with its chordae is left in place to protect the wall of the posterior left ventricle. Calcium deposits must be completely removed from the suturing site in a calcified valve. Calcium bits may not allow proper anchoring of the valve in place or loose calcium bits may travel in blood to cause emboli. The valve site is washed well with saline and suction.

Valve sizers are placed in the annulus to determine the size of the valve required for replacement. The prosthetic valve is then sutured around the mitral valve ring (annulus). The sutures are tied when the valve is seated in place. Saline is flushed through the prosthetic valve to check its competency. Some of the associated defects like atrial septal defect closure or aortic valve replacement can be corrected during this procedure. Before closing the left atrium, absence of air and clots are ensured to prevent thrombosis. Heart lung bypass machine is slowly weaned off. When the heart starts beating on its own again, the prosthetic valve function can be checked using trans thoracic echocardiogram. Drainage tubes will be placed in the chest to drain the excess fluids produced. The chest is then sutured in layers, dressed and bandaged.

Surgeons are currently trying a new less invasive method with newer technology. This procedure takes less time than the conventional method, also less time in the hospital and less recovery time.


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Patients undergoing mitral valve replacement are susceptible to the following risks. Bleeding, infection, complex reaction to anesthetic. The risk involved in most cases can be determined by the physician and it depends on a variety of factors such as the patient’s age, general condition, specific medical problems and heart functions.

Alternative treatment is Balloon valvuloplasty.Balloon valvuloplasty is performed using a catheter, i.e. a very thin flexible tube which can be inserted into the body, with a balloon at the end. The balloon is put inside the valve and is expanded thus stretching the valve and bringing it back to its normal size. For more info: heart-consult.com/articles.

can you pl guide me what to do i have mitral valve balooning twice after gap of 10 years and presently,I am only 30 years old.I am on acitrom 2 mg [Anticoagulant], metolar 25 mg and Penicilin 10 lacs once in three weeks.I am having feeling of irregular heart beating and sometimes irregular palpitations.I had undergone check up in 2008 june last time everything was ok and there was no need of balloning that time.Is it possible that there may be severe damage only in these two yaers that is between 2008 to 2010.Pl suggest and what could be the situation.

rolando

hallo, i am suffering from mitral valve stenosis for about 3.5jear. am like you help me without operation.

guest

My mother had sucessive surgery. I flew her to NYC to see Dr David Adams ..the worlds greatest in mitral valve repair and replacement. His entire team at Mount Sinai is fabulous. He see patients from around the world.

guest

i am suffering from Mitral stenosis(Moderate-severe)and Mitral regurgitation(Mild-moderate).The disease surfaced some 5/6 months back.i am intrested in the latest non surgical treatment.please guide/help me.thanks with regards,waiting for your reply.

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