MICS Heart Valve Surgery

Overview

Mitral valve surgery is surgery to either repair or replace the mitral valve in your heart.

Blood flows from the lungs and enters a pumping chamber of the heart called the left atrium. The blood then flows into the final pumping chamber of the heart called the left ventricle. The mitral valve is located between these two chambers. It makes sure that the blood keeps moving forward through the heart.

You may need surgery on your mitral valve if:

  • The mitral valve is hardened (calcified). This prevents blood from moving forward through the valve.
  • The mitral valve is too loose. Blood tends to flow backward when this occurs.

Minimally invasive mitral valve surgery is done through several small cuts. Another type of operation, open mitral valve surgery, requires a larger cut.

Description

Before your surgery, you will receive general anesthesia.

You will be asleep and pain-free.

There are several different ways to perform minimally invasive mitral valve surgery.

  • Your heart surgeon may make a 2-inch to 3-inch-long (5 to 7.5 centimeters) cut in the right part of your chest near the sternum (breastbone). Muscles in the area will be divided. This lets the surgeon reach the heart. A small cut is made in the left side of your heart so the surgeon can repair or replace the mitral valve.
  • In endoscopic surgery, your surgeon makes 1 to 4 small holes in your chest. Surgery is done through the cuts using a camera and special surgical tools. For robotically-assisted valve surgery, the surgeon makes 2 to 4 tiny cuts in your chest. The cuts are about 1/2 to 3/4 inches (1.5 to 2 centimeters) each. The surgeon uses a special computer to control robotic arms during the surgery. A 3D view of the heart and mitral valve are displayed on a computer in the operating room.

You will need a heart-lung machine for these types of surgery. You will be connected to this device through small cuts in the groin or on the chest.

If your surgeon can repair your mitral valve, you may have:

  • Ring annuloplasty — The surgeon tightens the valve by sewing a ring of metal, cloth, or tissue around the valve.
  • Valve repair — The surgeon trims, shapes, or rebuilds one or both of the flaps that open and close the valve.

You will need a new valve if there is too much damage to your mitral valve. This is called replacement surgery. Your surgeon may remove some or all of your mitral valve and sew a new one into place. There are two main types of new valves:

  • Mechanical — Made of man-made materials, such as titanium and carbon. These valves last the longest. You will need to take blood-thinning medicine, such as warfarin (Coumadin), for the rest of your life.
  • Biological — Made of human or animal tissue. These valves last 10 to 15 years or longer, but you will probably not need to take blood thinners for life.

The surgery may take 2 to 4 hours.

This surgery can sometimes be done through a groin artery, with no cuts on your chest. The doctor sends a catheter (flexible tube) with a balloon attached on the end. The balloon inflates to stretch the opening of the valve. This procedure is called percutaneous valvuloplasty and done for a blocked mitral valve.

A new procedure involves placing a catheter through an artery in the groin and clipping the valve to prevent the valve from leaking.