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In our first article about mitral valve diseases, we discussed the types of mitral valve diseases, what causes them and what their symptoms are.
In this second part, we’ll be discussing what it’s like to live with one of these diseases, treatment options, recovery and what life can be like after surgery.
Mitral Valve Regurgitation Treatment
If you have mild or moderate mitral valve regurgitation, you’ll likely never need any treatment, but you may need regular echocardiograms. Your health care provider might also prescribe medicines to help reduce the workload of the heart when your pump function isn’t working optimally.
You may also need additional medicine to slow your heart rate if you develop atrial fibrillation as well as blood thinners, or anticoagulants, to help prevent blood clots. Water pills, or diuretics, may also be part of your treatment plan to reduce swelling and improve symptoms.
Surgery may be needed with severe mitral valve regurgitation, and it is often needed right away for acute severe mitral valve regurgitation. Your surgeon may be able to repair the mitral valve, but in some cases, a replacement valve is required.
Depending on a number of factors, your surgeon might do open surgery or a minimally invasive procedure. If you have atrial fibrillation, the surgeon may do a Maze procedure. This is a type of heart surgery that can reduce the future risk of atrial fibrillation and in some cases, a clip can be used to reduce the amount of mitral regurgitation.
Moderate or severe mitral regurgitation can cause problems during pregnancy. If you’re planning on becoming pregnant, you should work with your doctors to develop a plan to ensure the best possible outcome for you and your baby.
Living with Mitral Valve Regurgitation
Moderate to severe mitral valve regurgitation often requires regular monitoring. Be sure to visit your health care provider right away if your symptoms change. Note your symptoms when exercising as they may get worse during physical activity and talk with your provider about your exercise program and what is right for you.
If you have progressive mitral regurgitation, your health care provider may advise avoiding competitive sports. Be sure to tell all of your health care providers and dentists about your medical history, as well.
Your health care provider may recommend a low salt, heart healthy diet in order to decrease blood pressure and the stress on your heart. They may also prescribe medication for blood pressure and to limit the risk of arrhythmia. They may also recommend you reduce your caffeine intake for the same reason.
Mitral Valve Prolapse (MVP) Treatment
MVP usually doesn't need to be treated because it’s rarely a serious condition and it doesn't damage the heart. Regular checkups with your doctor are advised, though.
If you have heart rhythm changes, you may need medicines to control fast heart rhythms or irregular heartbeats. In most cases, you’ll also need to limit stimulants, such as caffeine and nicotine, to control symptoms.
If you have atrial fibrillation or severe left atrial enlargement, you may need treatment with an anticoagulant in order to keep blood clots from forming. This can be in the form of aspirin, Warfarin therapy or other blood thinners.
If you have symptoms of dizziness or fainting, it's important to stay well-hydrated by drinking plenty of fluids.
If severe mitral regurgitation is from a floppy mitral flap, tear of the cords, or extreme lengthening of the valve, you may need transcatheter mitral valve repair, surgical repair, or valve replacement.
What Are the Possible Complications of Mitral Valve Prolapse?
Rarely, bacteria that enter the bloodstream can cause an infection of the inner lining of the heart chambers and valves. This risk is higher in people with MVP because the deformed mitral valve flap can attract bacteria in your bloodstream.
Gum infections and tooth decay can cause the same infection, so regularly flossing and brushing your teeth can help prevent it. You may be at high risk for it if you’ve had a valve replaced. Be sure to tell your dentist before you see them because you may need to take antibiotics before dental work and certain types of surgery.
Types of Mitral Valve Replacement
An open mitral valve replacement is a surgery to replace a poorly working mitral valve with an artificial valve. This will ensure blood can flow into the left ventricle and then flow out to the body normally, without putting extra stress on your heart.
Most people who have an open mitral valve replacement have a successful outcome, but there are still certain risks involved. Your particular risk will vary based on your overall health, your age and other factors. Talk with your health care provider about any concerns you have.
Possible risks include:
- Arrhythmia, possibly requiring a permanent pacemaker
- Blood clots leading to stroke or heart attack
- Complications from anesthesia
- Continued leaking of the valve
- Damage to nearby organs
- Memory loss or problems with concentration
Certain factors increase the risk of complications, such as:
- Chronic illness, including diabetes and kidney problems
- Other heart conditions
- Lung problems
- Increased age
- Vascular disease
Minimally Invasive Mitral Valve Replacement
Minimally invasive surgery is performed with small incisions and special small tools. A valve replacement surgery performed this way is faster, easier and requires less recovery time.
Some surgeons use robot-controlled arms to do the surgery and you should talk with your doctor about the risks and benefits of this kind of surgery.
How Do You Choose a New Valve?
Before the surgery, you and your doctor will talk about what kind of valve will work best for you. You may be given a biological valve. This is a valve made from cow, pig or human heart tissue. Or, you may be given a mechanical valve. This is an artificial valve made from metal and other materials.
Each type of valve has different risks and benefits. Biological valves need to be replaced in 10 to 15 years, while mechanical valves are far more durable and can last for a very long time, but you’ll need to take blood-thinner medicine for the rest of your life. This is to help prevent clots that can form on the valve and may cause stroke or the functioning part of the valve to become stuck. Make sure to talk with your doctor about follow-up care needed for each type.
What Happens After a Mitral Valve Replacement?
In the Hospital
Most people who have mitral valve replacement notice immediate symptom relief after their surgery.
Your surgical team will continue to carefully monitor your vital signs, such as your heart rate, blood pressure, and breathing.
Soon after surgery, you’ll likely be encouraged to get up and sit in a chair and perform breathing therapy. In a day or two, you should be able to walk with help.
You may need to wear elastic stockings or compression devices on your legs to help blood circulate through your leg veins and you’ll probably need to stay in the hospital for anywhere between three and eight days, depending on your overall health and what type of surgery you had.
Make sure you have someone to drive you home from the hospital and have someone able to lend some help at home for a while. Be aware that you may tire easily after the surgery, but you’ll gradually start to recover your strength. It may take several weeks to fully feel like yourself again after surgery, but you should be feeling relief from your previous symptoms.
After you go home, take your temperature, monitor your blood pressure and weigh yourself every day. Keep records and call your health care provider with any significant or concerning changes.
Follow all of the instructions your health care provider gives you for driving, medicines, exercise, diet, and wound care. If you have a mechanical valve, you’ll likely need to take blood-thinning medicine, and some may require blood tests to check the how the medicine is working.
Keep all your follow-up appointments and follow your health care provider's suggestions about beginning a cardiac rehabilitation program, which begins in the hospital with simple walking and progresses to a regular exercise routine. It also includes education about eating a nutritious diet. Committing to healthier habits can prevent future heart problems.