Mitral valve surgery for Pulmonary Hypertension

Overview
In some people with pulmonary hypertension (PH), the disease is caused by damage or a defect of the mitral valve of the heart. Mitral valve surgery can potentially be an effective treatment for PH in certain cases.

The heart has four valves: Mitral, tricuspid, aortic, and pulmonary. Each valve opens enough to let blood flow through into the next heart chamber, and then closes to prevent the blood from flowing backward. The mitral valve, which is also called also known as the bicuspid valve or left atrioventricular valve, lets oxygen-rich blood flow from the left atrium into the left ventricle, which then pumps it around the body. Mitral valve surgery aims to repair or replace a damaged or defective mitral valve. Mitral valve surgery is a common procedure.

What does it involve?
Mitral valve surgery may be performed alone or during another heart surgery such as coronary artery bypass grafting (CABG). The mitral valve may be repaired or replaced. Valves may be replaced with either artificial (also known as mechanical or prosthetic) valves or biological valves made of human or animal tissue.

You will be under general anesthetic for mitral valve surgery. Depending on the type of heart valve surgery you are having, the surgeon may use open-heart technique or a newer, less invasive method such as keyhole surgery, which is performed using very small incisions, or robotic procedures.

In open-heart surgery, the surgeon makes a long incision down the chest, cuts the sternum in half, and spreads the rib cage apart. The heart is then temporarily stopped while grafting surgery is performed. While the heart is stopped, blood will continue to be pumped through the body by a cardiopulmonary bypass (heart-lung) machine. Once the valve repair or replacement is complete, the heart is restarted, and normal blood flow is restored. The surgeon will then close the chest.

Recovery
After heart valve surgery, you will spend one or two days in the intensive care unit (ICU) where your condition can be monitored regularly. You will continue recovery in another part of the hospital for an additional three to five days before returning home. You can expect to return to work and resume normal activities after four to eight weeks. Your cardiologist may recommend cardiac rehabilitation after heart valve surgery.

Results
Mitral valve surgery has a high success rate. This procedure can relieve PH symptoms and prolong life in the right candidate.

Constraints
Any surgery carries risks of complications including blood clots, blood loss, infection, breathing problems, reactions to medication, kidney failure, heart attack or stroke during the surgery, and death. Complications specific to heart surgery include postpericardiotomy syndrome, which can cause chest pain and low-grade fever lasting several months.

You may need to take blood thinners for the rest of your life following heart valve replacement. This is more likely if you receive an artificial valve, since artificial valves are known to develop blood clots.

Biological replacement valves last 12 to 15 years. Artificial valves last eight to 20 years. You may require additional heart valve surgery in the future to repair or replace the new valve.

For more details about this treatment, visit:

Mitral Valve Surgery Identified As Potential Treatment For PAH Secondary to Mitral Valve Disease – Pulmonary Hypertension News
https://pulmonaryhypertensionnews.com/2015/05/1...

Mitral valve disease often missed in pulmonary hypertension – Chest Physician
http://www.mdedge.com/chestphysician/article/11...

Heart valve surgery – MedlinePlus
https://medlineplus.gov/ency/article/002954.htm

What is heart valve surgery? (PDF) – American Heart Association
https://www.heart.org/idc/groups/heart-public/@...

Heart valve surgery – Mayo Clinic
http://www.mayoclinic.org/tests-procedures/hear...