Mitral valve repair or replacement (sternotomy)

Mitral Valve Repair/Replacement – Sternotomy

The traditional way to perform a mitral valve replacement is by open-heart surgery, dividing the breastbone (sternum).  This is known as a sternotomy and leaves a 9-12 inch scar on the front of the chest.  The sternotomy, is still used for the majority of cardiac surgery procedures as it gives very wide access for the surgeon to perform the operation.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes between two and three hours.

If the mitral valve flaps can be repaired, the surgeon will make an incision along your chest and partially clip or sew the flaps so that amount of blood leaking is reduced.

If the valve cannot be repaired, the surgeon will have to replace the valve with either a mechanical valve or a tissue one. You will be connected to a heart-lung machine, which allows the heart to be opened and the valve replaced or repaired.

The consultant will explain the procedure step by step, answering every question you might have.

What are the risks of the surgery?

The two types of surgeries are generally successful, however, as with every surgery, complications can always arise. The mitral valve replacement surgery has a higher risk of life-threatening problems than the repair surgery.

Any surgery carries certain risks such as pain,  bleeding, unsightly scarring, blood clots, blood loss, breathing problems, infection, allergic reactions to the medicines

Specific risks of this surgery could be:

• Stroke
• Infection in the chest wound
• Heart attack
• Death

How soon will I recover?

After the operation you will be transferred to the cardiac intensive-care unit or high-dependency unit, usually for 24 hours, and then to the ward.

You should be able to go home after seven to ten days.

It can take the patient an average of two to three months to recover from this type of operation.

There are also a number of important lifestyle limitations, which give time for the breastbone to heal back together, including:

• No driving for six weeks
• No lifting of anything heavier than a bag of sugar for six weeks
• No pushing up from a bed or chair with your arms for six weeks

Your surgeon, physiotherapist and occupational therapist will discuss your individual case with you and offer personal advice as to when you can return to normal activities.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.

Most people make a good recovery, with no more breathlessness or chest pain. You may have more energy after you recover.