Mitral valve repair / replacement (MVR) | Dr Samson Olori

What is mitral valve disease?

The mitral valve sits between the left atrium and left ventricle and ensures blood flows forward into the ventricle. When it does not open fully (stenosis), blood backs up and pressure in the lungs can rise. When it does not close properly (regurgitation), blood leaks back into the atrium. Causes include mitral valve prolapse (floppy valve), rheumatic heart disease (after strep infection), infection (endocarditis), and degenerative changes. Symptoms can include breathlessness, fatigue, chest pain, palpitations, and swelling of the legs. Severe disease can lead to heart failure, atrial fibrillation, or pulmonary hypertension. Surgery is recommended when the valve is severely diseased, symptoms are present, or the heart is enlarging or weakening.

Repair vs replacement

Repair is preferred when possible: it preserves your own valve and often avoids the need for long-term blood thinners. The surgeon may reshape, trim, or support the valve. When repair is not feasible, the valve is replaced with a mechanical valve (durable but requires lifelong anticoagulation) or a biological valve (from human or animal tissue; may not need blood thinners but can wear out over years). The operation is done under general anaesthesia, usually with a heart-lung machine. Recovery typically involves several days in hospital and a few weeks to months for full recovery. Risks include bleeding, infection, stroke, arrhythmias, and valve-related complications. We can refer you to a cardiac surgeon for assessment and to discuss the best option for you.

Diagnosis and recovery

Mitral valve disease is diagnosed by symptoms, examination (heart murmur), echocardiography (ultrasound of the heart), and sometimes stress tests or cardiac MRI. Your cardiologist will assess severity and timing for surgery. After the operation, you will be monitored in hospital; most people go home within about a week. You will need to care for the wound, avoid heavy lifting and driving for a period, and take any prescribed medicines (including blood thinners if you have a mechanical valve). Follow-up echocardiograms are done to check the valve and heart function. With a successful repair or replacement, symptoms usually improve and long-term outlook is good. We can refer you to a cardiac surgeon and arrange follow-up care.

Frequently asked questions

Is repair better than replacement?
When the valve can be repaired, it is often preferred: it may preserve heart function better and avoid the need for lifelong blood thinners (required with mechanical valves). Your surgeon will advise based on your valve anatomy.
What are the risks of mitral valve surgery?
Risks include bleeding, infection, stroke, arrhythmias, and failure or infection of the new valve. Your cardiac team will explain how these are minimised and managed.
How long is recovery?
Most people stay in hospital for about 5–7 days. Full recovery may take several weeks to months. You will need follow-up to check the valve and heart function.
When should I have mitral valve surgery?
Surgery is usually recommended when the valve is severely leaky or narrowed, you have symptoms (e.g. breathlessness, fatigue), or tests show the heart is enlarging or weakening. Your cardiologist will advise on the best timing.