MITRAL VALVE REPLACEMENT

What You Should Know:

• Mitral (MI-trul) valve replacement is surgery to put a new mitral valve in your heart. Your heart has 4 chambers or rooms. The atria (A-tree-uh) are the two rooms that receive blood from the body. The ventricles (VEN-trik-ulls) are the two rooms that pump blood out of the heart. There are valves (doors) between the atria and ventricles that open to let blood enter the ventricles. The valves also keep blood from flowing backward from the ventricles into the atria. The mitral valve is between the left atrium (A-tree-um) and the left ventricle.
  
• The mitral valve is made up of two smaller leaflets. The leaflets come from the back and front of the valve and meet in the middle. During surgery, part or all of your mitral valve is removed and replaced with an animal, human, or man-made valve. There are two common reasons why you may need a new mitral valve:
  
• Mitral valve prolapse:Mitral valve prolapse is the medical name for when the mitral valve leaflets do not close correctly. Part of one, or part of both leaflets slip backward into the left atrium. When blood leaks backward through the valve, from the ventricle to the atrium, this is called mitral regurgitation (ree-ger-jih-TA-shun).
  
• Mitral valve stenosis (sten-O-sis):In mitral valve stenosis the leaflets cannot open all the way. Stenosis means narrow or tight. A narrow valve makes it harder for blood to leave the left atrium and get into the left ventricle.

GETTING READY:

The Week Before Surgery: 

• Ask your caregiver if you need to stop taking aspirin or any other blood thinning medicines before your procedure.
  
• Ask your caregiver before taking any over-the-counter medicine, vitamins, herbs, food supplements, or laxatives.
  
• You may be given a tour of the ICU before your surgery to help you become familiar with where you will go after surgery.
  
• You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.
  
• If caregivers think you may need a blood transfusion during surgery, you may be able to donate your own blood before surgery. This is called autologous (ah-TALL-uh-gus) blood donation. This must be done no later than several days before surgery. You may also ask a family member or friend with the same blood type to donate their blood. This is called directed blood donation. Talk to your caregiver for more information on autologous or directed blood donation as soon as you know you are having the surgery.

The Night Before Surgery: 

• You may be given a pill to take to help you sleep.
  
• Ask caregivers about directions for eating and drinking.
  

The Day of Your surgery: 

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, blood pressure pills, and heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Do not wear contact lenses on the day of surgery. You may wear glasses.
  
  
• Bring necessary personal belongings, such as a toothbrush, to the hospital with you.
  
  
• An anesthesiologist will talk to you before your surgery. This caregiver will give you medicine to make you sleep during surgery.
  
  
• You or a close family member may be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do surgery. It also explains the possible problems that can happen with surgery and your choices. Be sure all of your questions have been answered before you sign this form.
  
  
• Ask a family member or friend to drive you home when you leave the hospital. Do not drive yourself home.

During Surgery: 

• A caregiver will clean your chest with soap and water. This soap may make your skin yellow, but it will be cleaned off later. Sheets will be put over you to keep the surgery area clean. An incision (cut) may be made in the middle of your chest. One or more incisions may be made on the right side of your chest.
  
  
• You are then connected to a heart-lung bypass machine. This machine does the work of your heart and lungs when your heart is stopped during surgery. Part or all of your mitral valve will be removed and replaced with an animal, human, or man-made valve. The type of valve chosen depends on several things. Your caregiver may not be able to tell you for sure before surgery the kind of replacement valve to be used. The valve is sewn in place. Then your heart is checked to make sure there is no bleeding and to remove air from inside your heart.
  
  
• The heart-lung machine is stopped and your own heart and lungs will start working again. A TEE or transesophageal (trans-eh-sof-uh-G-ull) echocardiogram (eh-ko-KAR-d-o-gram) may be done to see how well the valve and your heart are working. The incision in your chest is closed with wire and stitches (thread) or staples.

After Surgery: You are taken to the recovery room or an intensive care unit (ICU). Caregivers will watch you very closely. A bandage is used to cover your stitches or staples. The bandage keeps the area clean and dry to prevent infection. A caregiver may remove the dressing shortly after surgery to check the stitches.  Do not get out of bed until your caregiver says it is OK.  Additional instructions will be provided by your caregivers to lead you to recovery. Your family may be allowed to visit you in the ICU for a short visit several times a day.

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