Do you need to replace the mitral valve in your heart? (Mitral Valve Replacement) Let's talk about this simply!

Has your doctor told you that your mitral valve is weak and that you need surgery? It's normal to feel a little scared and worried when you hear something like this. But don't worry. This is a very advanced and successful surgery now. Today, we'll talk about Mitral Valve Replacement, what it means, why it's done, and how it's done, in a very simple way that you can understand.

First, let's see, what is this mitral valve?

Think of your heart as a house with four rooms. There are doors between these rooms that allow blood to flow back and forth. These doors only open in one direction. So, this mitral valve is a very important door between the upper chamber (left atrium) and the lower chamber (left ventricle) on the left side of the heart.

The oxygen-rich, clean blood from the lungs first enters this upper chamber on the left. Then, the mitral valve opens and that blood goes into the lower chamber. It is from the lower chamber that blood is pumped throughout the body. So this door, that is, the valve, has to open and close at just the right time.

But due to some diseases, this valve does not work properly. Then the heart feels a lot of pressure. Over time, this can damage the heart and lungs.

In what cases does a mitral valve need to be replaced?

This surgery is required mainly due to two medical conditions.

1. Mitral regurgitation: This is when the valve doesn't close properly. Then some of the blood that went into the lower chamber leaks back into the upper chamber. It's like a broken door lock.

2. Mitral Stenosis: What happens here is that the valve doesn't open properly. It becomes narrow and blocked. Then the path for blood to flow from the upper chamber to the lower chamber is blocked. It's like a door is stuck.

The valve may not be repairable for the following reasons:

• If the valve is severely damaged due to an infection in the heart (endocarditis).
• If the valve has become scarred and thickened due to rheumatic heart disease (Rheumatic Heart Disease) that occurred during childhood.
• If calcium deposits have formed on the valve and become stone-like.
• If the delicate cord system (papillary muscles or chordae) that support the valve is damaged.

What are the new types of valves?

If you are getting a new valve, there are two main types to choose from. Both have their pros and cons. You and your doctor will need to decide together which is best for you, based on your age, lifestyle, and health.

Doctors usually use a guideline like this:

• If under 50 years old: a mechanical valve (unless pregnant or planning to become pregnant).
• If between 50 and 65 years old: any of the two types.
• If over 65 years old: a biological valve.

This is a big decision, so don't hesitate to discuss any questions or fears you have with your doctor.

What happens before and during the surgery?

Preparation before surgery

Your doctor will give you instructions on how to prepare for surgery. You will usually need to do the following:

• Stop taking certain medications (especially blood thinners) a few weeks before surgery.
• If you smoke, stop it completely.
• Wash your body with an antiseptic soap the night before surgery.
• Stop eating and drinking from midnight the night before surgery.
• Arrange for someone to help you when you get home. You may find it difficult to do heavy lifting or cook for a while. Therefore, it is very important to get help from a family member or friend.

During surgery

This is usually an open-heart surgery. This means the surgery is done through an opening in the chest. However, some people can have the surgery done through a catheter (transcatheter). Your doctor will decide if this is right for you.

During surgery:

1. You will be completely anesthetized. So you won't feel or remember anything.

2. During the surgery, you will be connected to a special machine (Cardiopulmonary Bypass Machine) to do the work of your heart and lungs.

3. The surgeon makes an incision in the chest and reaches the heart.

4. Then, the damaged mitral valve is carefully removed, and the new valve is sewn in place. Doctors try to save as much of your own healthy tissue as possible.

5. The new valve is checked to make sure it is working properly, the chest is closed, and you are then removed from the heart-lung machine.

This surgery usually takes about two to four hours.

After surgery and recovery

You will have to stay in the hospital for about a week after the surgery.

• You will spend the first day or two in the intensive care unit (ICU), where everything from your heartbeat to your breathing will be closely monitored.
• Then they are transferred to a regular ward.
• It is common to experience irregular heartbeats (`Arrhythmias`) after surgery. Medication is given for this.
• Medication to prevent blood clotting (anticoagulation therapy) is started.
• You will be referred to a cardiac rehabilitation program to speed up your recovery.

It usually takes between 4 and 8 weeks to recover. But this varies from person to person. This time can vary depending on things like your age and your pre-surgery health. So don't rush it. Listen to your body and get plenty of rest.

What are the risk symptoms that you should immediately report to your doctor?

If you experience any of the following symptoms after returning home, do not ignore them. Call your doctor immediately or go to the nearest hospital Emergency Department (ETU).

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