Do you have shortness of breath, chest pain, or feel tired easily? Your doctor may have told you that you have a small weakness in one of your heart valves. Many people are afraid of heart surgery. But today we are going to talk about a modern surgery that repairs a heart valve through a very small incision, without making a large cut in the middle of the chest.
First, let's see, what is the Mitral Valve?
Okay, just think of it this way: our heart is like a small house with four chambers. Between these chambers are four gates that help blood flow in only one direction. These are what we call heart valves.
The mitral valve is one such special gate. It is located between the upper chamber (left atrium) and the lower chamber (left ventricle) on the left side of your heart. Its main job is to allow blood to flow from the upper chamber to the lower chamber and prevent it from flowing back up. It's like a door that only opens one way.
So what are the main diseases that can affect this valve?
There are two main ways in which the mitral valve can malfunction. Understanding these will help you better understand this surgery.
| Condition | Simply put, what happens? |
|---|---|
| Mitral Valve Regurgitation | What happens in this is that when the heart beats, the two flaps of the valve don't close properly. It's like a door that doesn't close properly. Then some blood leaks back into the upper chamber. This causes the heart to work harder. |
| Mitral Valve Stenosis | What happens here is that the valve flaps become thick, stiff , and do not open properly. This narrows the passageway for blood to flow through. This makes it difficult for the heart to pump enough blood to the body. |
What is the difference between 'Repair' and 'Replacement'?
This is also a very important matter.
- Repair: This involves keeping your own valve and fixing the defect. It's like repairing a broken chair. Doctors try to go with this method whenever possible.
- Replacement: In this procedure, your weakened valve is completely removed and a new valve (either artificial or made from animal tissue) is implanted in its place.
It is best for the body to repair and use your own natural valve whenever possible, which is why these 'repair' surgeries are so popular now.
What is Minimally Invasive Surgery?
Traditional open-heart surgery involves making a large incision several inches long in the middle of the chest, cutting through the breastbone to reach the heart. This is a very major operation.
But in this modern method called minimally invasive surgery, such a large incision is not made. Instead, a small incision is made on the right side of your chest, between the ribs, about 4-6 centimeters . Then, a thin tube with a camera attached (`(endoscope)`) and very fine surgical instruments are inserted through that incision and, under the supervision of a monitor, the valve is repaired very delicately. Sometimes robotic technology is also used for this.
What repairs are done during this surgery?
The doctor can do different things depending on the problem with your valve.
- A ring-like structure is placed around the valve to stop blood from leaking (Annuloplasty).
- If the valve flaps are connected, they are separated.
- If there is a hole in the valve, it is closed.
- Unnecessary tissue that prevents the valve from closing properly is removed.
What are the benefits and risks of this surgery?
Like any surgery, there are both benefits and risks, and it's important to be aware of them.
| 👍 Advantages | 👎 Risks |
|---|---|
| The recovery time is short. | Bleeding and blood clotting. |
| The pain is less. | Infection. |
| The number of days you stay in the hospital is short (about 5 days). | Irregular heartbeat (`(Arrhythmias)`). |
| The scar is very small. | Small chance of stroke. |
| The risk of infection and bleeding is low. |
What happens after the surgery?
The surgery usually takes about two to four hours. After that, you will be kept under observation in the intensive care unit (ICU) for a day or two. After that, you will be transferred to a regular ward.
- Early days: Doctors and nurses will help you get up and walk. If there is mucus in your lungs, they will tell you to do special breathing exercises to get rid of it.
- After you go home: You will feel a little tired for a few weeks. Avoid lifting heavy objects. Exercise as your doctor tells you to.
- Cardiac Rehabilitation: In most cases, you will be referred to a cardiac rehabilitation program. This will help you gradually regain strength and adapt to a healthy lifestyle.
When to see a doctor immediately!
If you develop any of these symptoms after you return home, call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).
- If a pus-like fluid is draining from the surgical incision.
- If there is excessive swelling and redness around the incision.
- If you have a fever and chills.
- If you feel your heart beating fast (heart palpitations).
- If the legs swell abnormally (`(Edema)`).
- If you gain more than 1.5 kg (3 pounds) in weight in a week.
Remember, not everyone can have this surgery. Your heart surgeon will decide whether you are a good candidate for this surgery based on your heart condition, other medical conditions, age, and lifestyle (such as smoking).
Take-Home Message
- Minimally Invasive Mitral Valve Repair is a modern heart surgery performed through a small incision, without completely opening the chest.
- The main advantages of this are reduced pain, faster recovery, and reduced time spent in the hospital.
- This can help repair and protect your own natural valve.
- This surgery is not suitable for everyone. Your cardiac surgeon is the best person to make the decision about it.
- If any risk symptoms arise after surgery, it is essential to seek medical advice immediately.
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