When there are patients with severe mitral valve prolapse, mitral stenosis, or other mitral valve disease, a mitral valve repair/replacement is the surgical treatment.  Either the surgeon can repair the patient's mitral valve or can replace it with a prosthetic valve.  Prosthetic valves can either be mechanical (made out of metal, last longer, requires anticoagulation) or biological (human or animal tissue, less anticoagulation, shorter life of valve).  

Pre-Operative Details:

Your surgeon will give specific instructions before the surgery, including risks (i.e. bleeding, infection, adverse reaction to anesthesia, etc.).  Please make sure to contact your insurance company for coverage.  You will also meet with the anesthesiologist prior to the surgery to go over your medical history.  Please do not eat after midnight the night before your surgery.  On the day of surgery, you will arrive at the hospital, get registered, and get changed into a hospital gown.  A nurse will then review your chart to make sure there are no problems and then get all the paperwork in order for surgery.  The anesthesiologist will then start an IV and you will be taken to the operating room, where the surgeon will verify your name and procedure before any medication is given.  Once you are under anesthesia, surgery will begin.

Operative Details:

The surgeon will begin by making an incision in the midline of the chest and spread the chest cavity to get to the heart.  The patient will then be placed on cardiopulmonary bypass (allows blood to be pumped to body bypassing the heart except for the coronary arteries) and the heart is stopped temporarily.  An incision is made in the left atrium of the heart to access the mitral valve, and it is then either repaired or replaced. If the valve is replaced, the patient's mitral valve leaflets are taken out first before the prosthetic valve is placed.  The heart is then closed and the heart is restarted and blood is allowed to flow back through the heart.  Pacing wires are placed on the heart in case there are any irregular heart rhythms during the recovery period in the hospital, and the chest is closed with wires and stitches.

Post-Operative Details:

After the surgery, you will be taken to the intensive care unit and be monitored.  You will likely experience pain and will given pain medication appropriately.  You may also be on a respirator for up to day after the surgery.  It is important to keep the incision areas clean and dry.  The length of your hospital stay depends on how quickly you are able to recover and perform some physical activity.  If you experience fevers, severe pain, redness/swelling/warmth where the incisions were made, or drainage from the incisions, please let your doctor know immediately.  Your surgeon will give specific instructions about recovery time.